1
|
Paré C, Yamada K, Sullivan MJL. Temporal Relations Between Pain Catastrophizing and Adverse Health and Mental Health Outcomes After Whiplash Injury. Clin J Pain 2024; 40:10-17. [PMID: 37855307 DOI: 10.1097/ajp.0000000000001168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 10/11/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVES Pain catastrophizing has been shown to be a prognostic indicator for pain severity and the co-occurrence of mental health conditions such as depression and post-traumatic stress disorder after whiplash injury. However, the pattern of available findings is limited in its implications for the possible "antecedent" or "causal" role of pain catastrophizing. The purpose of the present study was to examine the temporal relations between pain catastrophizing, pain severity, depressive symptoms, and post-traumatic stress symptoms (PTSS) in individuals receiving treatment for whiplash injury. MATERIALS AND METHODS The sample consisted of 388 individuals enrolled in a multidisciplinary program for whiplash injury. Participants completed self-report measures of pain catastrophizing, pain severity, depressive symptoms, and PTSS at the time of admission, mid-treatment (4 week), and treatment completion (7 week). A cross-lagged panel analysis was used to examine the temporal relations between pain catastrophizing, pain severity, depressive symptoms, and PTSS across all 3 timepoints. RESULTS Model fit was acceptable after the inclusion of modification indices. Pain catastrophizing at the time of admission predicted all other variables at 4 weeks. Pain catastrophizing at 4 weeks also predicted all other variables at 7 weeks. In addition, some bidirectional relations were present, particularly for variables assessed at week 4 and week 7. DISCUSSION Findings support the view that pain catastrophizing might play a transdiagnostic role in the onset and maintenance of health and mental health conditions. The findings call for greater emphasis on the development of treatment techniques that target pain catastrophizing in intervention programs for whiplash injury.
Collapse
Affiliation(s)
- Catherine Paré
- Department of Psychology, McGill University, Montréal, QC, Canada
| | - Keiko Yamada
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | | |
Collapse
|
2
|
Personalized behavior management as a replacement for medications for pain control and mood regulation. Sci Rep 2021; 11:20297. [PMID: 34645900 PMCID: PMC8514566 DOI: 10.1038/s41598-021-99803-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 09/29/2021] [Indexed: 12/12/2022] Open
Abstract
A lack of personalized approaches in non-medication pain management has prevented these alternative forms of treatment from achieving the desired efficacy. One hundred and ten female patients with fibromyalgia syndrome (FMS) and 60 healthy women without chronic pain were assessed for severity of chronic or retrospective occasional pain, respectively, along with alexithymia, depression, anxiety, coping strategies, and personality traits. All analyses were conducted following a ‘resource matching’ hypothesis predicting that to be effective, a behavioral coping mechanism diverting or producing cognitive resources should correspond to particular mechanisms regulating pain severity in the patient. Moderated mediation analysis found that extraverts could effectively cope with chronic pain and avoid the use of medications for pain and mood management by lowering depressive symptoms through the use of distraction mechanism as a habitual (‘out-of-touch-with-reality’) behavior. However, introverts could effectively cope with chronic pain and avoid the use of medications by lowering catastrophizing through the use of distraction mechanism as a situational (‘in-touch-with-reality’) behavior. Thus, personalized behavior management techniques applied according to a mechanism of capturing or diverting the main individual ‘resource’ of the pain experience from its ‘feeding’ to supporting another activity may increase efficacy in the reduction of pain severity along with decreasing the need for pain relief and mood-stabilizing medications.
Collapse
|
3
|
Tenti M, Raffaeli W, Gremigni P. A Narrative Review of the Assessment of Depression in Chronic Pain. Pain Manag Nurs 2021; 23:158-167. [PMID: 33962870 DOI: 10.1016/j.pmn.2021.03.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 03/02/2021] [Accepted: 03/29/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVES This narrative review sought to explore the main critical issues in the assessment of depression in chronic pain and to identify self-report tools that can be reliably used for measuring it. DESIGN Narrative review of the literature. METHODS Articles were obtained through a search of three databases and a hand search of the references of full-text papers. Key results within the retrieved articles were summarized and integrated to address the review objectives. RESULTS Criterion contamination, different ways to define and evaluate pain and depression across studies, variability in chronic pain samples and settings, pitfalls of diagnostic systems and self-reports, and reluctance to address (or difficulty of recognizing) depression in patients and healthcare providers emerged as main critical issues. The Beck Depression Inventory seems to be the more accurate tool to evaluate depression in chronic pain patients, while other instruments such as the Patient Health Questionnaire could be recommended for a rapid screening. CONCLUSIONS Assessment of depression comorbidity in chronic pain represents a challenge in both research and clinical practice; the choice and use of tests, as well as the score interpretation, require clinical reasoning. NURSING PRACTICE IMPLICATIONS Nurses play an important role in screening for depression. Cognitive contents of depression should be carefully evaluated since somatic symptoms may be confusing in the chronic pain context. Some self-reports may be useful for rapid screening. It is also advisable to consider other relevant patient information in evaluating depression.
Collapse
Affiliation(s)
- Michael Tenti
- Fondazione ISAL, Institute for Research on Pain, Torre Pedrera, Italy
| | - William Raffaeli
- Fondazione ISAL, Institute for Research on Pain, Torre Pedrera, Italy.
| | - Paola Gremigni
- Department of Psychology, University of Bologna, Bologna, Italy
| |
Collapse
|
4
|
Giannitrapani KF, Haverfield MC, Lo NK, McCaa MD, Timko C, Dobscha SK, Kerns RD, Lorenz KA. "Asking Is Never Bad, I Would Venture on That": Patients' Perspectives on Routine Pain Screening in VA Primary Care. PAIN MEDICINE 2020; 21:2163-2171. [PMID: 32142132 DOI: 10.1093/pm/pnaa016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Screening for pain in routine care is one of the efforts that the Veterans Health Administration has adopted in its national pain management strategy. We aimed to understand patients' perspectives and preferences about the experience of being screened for pain in primary care. DESIGN Semistructured interviews captured patient perceptions and preferences of pain screening, assessment, and management. SUBJECTS We completed interviews with 36 patients: 29 males and seven females ranging in age from 28 to 94 years from three geographically distinct VA health care systems. METHODS We evaluated transcripts using constant comparison and identified emergent themes. RESULTS Theme 1: Pain screening can "determine the tone of the examination"; Theme 2: Screening can initiate communication about pain; Theme 3: Screening can facilitate patient recall and reflection; Theme 4: Screening for pain may help identify under-reported psychological pain, mental distress, and suicidality; Theme 5: Patient recommendations about how to improve screening for pain. CONCLUSION Our results indicate that patients perceive meaningful, positive impacts of routine pain screening that as yet have not been considered in the literature. Specifically, screening for pain may help capture mental health concerns that may otherwise not emerge.
Collapse
Affiliation(s)
- Karleen F Giannitrapani
- VA Palo Alto Health Care System, Center for Innovation to Implementation (Ci2i), Menlo Park, California.,Stanford University, Palo Alto, California
| | - Marie C Haverfield
- VA Palo Alto Health Care System, Center for Innovation to Implementation (Ci2i), Menlo Park, California.,Stanford University, Palo Alto, California
| | - Natalie K Lo
- VA Palo Alto Health Care System, Center for Innovation to Implementation (Ci2i), Menlo Park, California
| | - Matthew D McCaa
- VA Palo Alto Health Care System, Center for Innovation to Implementation (Ci2i), Menlo Park, California
| | - Christine Timko
- VA Palo Alto Health Care System, Center for Innovation to Implementation (Ci2i), Menlo Park, California.,Stanford University, Palo Alto, California
| | - Steven K Dobscha
- VA Portland Healthcare System, Center to Improve Veteran Involvement in Care (CIVIC), Portland, Oregon.,Department of Psychiatry, Oregon Health and Science University, Portland, Oregon
| | - Robert D Kerns
- VA Connecticut Healthcare System, Pain Research, Informatics, Multimorbidities and Education (PRIME) Center of Innovation, West Haven, Connecticut.,Department of Psychiatry, Neurology and Psychology, Yale School of Medicine, New Haven, Connecticut
| | - Karl A Lorenz
- VA Palo Alto Health Care System, Center for Innovation to Implementation (Ci2i), Menlo Park, California.,Stanford University, Palo Alto, California.,Department of Psychiatry, Neurology and Psychology, Yale School of Medicine, New Haven, Connecticut
| |
Collapse
|
5
|
The Relationship Between Level of Catastrophizing and Mental Health Comorbidity in Individuals With Whiplash Injuries. Clin J Pain 2019; 35:880-886. [PMID: 31433319 DOI: 10.1097/ajp.0000000000000749] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Pain catastrophizing has been shown to be correlated with measures of mental health problems such as depression and post-traumatic stress disorder (PTSD). However, the clinical implications of findings reported to date remain unclear. To date, no study has been conducted to determine meaningful cut-scores on measures of catastrophizing indicative of the heightened risk of mental health comorbidity. One objective of the present study was to identify the cut-score on the Pain Catastrophizing Scale (PCS) indicative of the heightened risk of the comorbidity of depression and PTSD. A second objective was to determine whether mental health comorbidity mediated the relationship between catastrophizing and occupational disability. MATERIALS AND METHODS The sample consisted of 143 individuals with whiplash injuries. Pain severity, pain catastrophizing, depression, and post-traumatic stress symptoms were assessed after admission to a rehabilitation program. Mental health comorbidity was operationally defined as obtaining a score above the clinical threshold on measures of depressive and/or post-traumatic stress symptom severity. RESULTS A receiver operating characteristic curve analysis revealed that a PCS score of 22 best distinguished between participants with and without mental health comorbidity. Results also revealed that mental health comorbidity mediated the relationship between catastrophizing and occupational disability. DISCUSSION The findings suggest that a score of ≥22 on the PCS should alert clinicians to the possibility that patients might also be experiencing clinically significant symptoms of depression or PTSD. Greater attention to the detection and treatment of mental health conditions associated with whiplash injury might contribute to more positive recovery outcomes.
Collapse
|
6
|
Toledano-Toledano F, Contreras-Valdez JA. Validity and reliability of the Beck Depression Inventory II (BDI-II) in family caregivers of children with chronic diseases. PLoS One 2018; 13:e0206917. [PMID: 30485299 PMCID: PMC6261561 DOI: 10.1371/journal.pone.0206917] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 10/22/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Information on the psychometric properties of the Beck Depression Inventory II (BDI-II) in family caregivers of children with chronic diseases is currently unavailable, indicating a significant gap in the literature. Therefore, we investigated 1) which of the five evaluated measurement models had the best fit, 2) the scale's reliability, and 3) the scale's convergent validity. METHODS In 2018, a cross-sectional ex post facto study with non-probability convenience sampling was conducted in 446 family caregivers of children with chronic diseases at the National Institute of Health in Mexico City; the family caregivers responded to the BDI-II and a battery of instruments measuring anxiety, caregiver burden, parental stress, well-being, and quality of life. A confirmatory factor analysis was conducted to determine the fit of the five models. Cronbach's alpha and composite reliability were calculated to assess the scale's reliability, and Spearman´s rank correlation was used to investigate the scale's convergent validity. RESULTS This study provided evidence that the two-factor somatic-affective and cognitive model had the best fit. The BDI-II demonstrated adequate reliability and evidence of convergent validity, as the BDI-II factors were positively correlated with anxiety, caregiver burden, and parental stress and negatively correlated with well-being and quality of life. CONCLUSIONS The findings reveal that the BDI-II is a valid, reliable, and culturally relevant instrument to measure depression in family caregivers of children with chronic diseases.
Collapse
Affiliation(s)
- Filiberto Toledano-Toledano
- Unidad de Investigación en Medicina Basada en Evidencias, Hospital Infantil de México Federico Gómez Instituto Nacional de Salud, México City, México
| | | |
Collapse
|
7
|
Psychological Characteristics of Chronic Pain: a Review of Current Evidence and Assessment Tools to Enhance Treatment. Curr Pain Headache Rep 2018. [DOI: 10.1007/s11916-018-0663-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
8
|
Skinner ML, Hong S, Herrenkohl TI, Brown EC, Lee JO, Jung H. Longitudinal Effects of Early Childhood Maltreatment on Co-Occurring Substance Misuse and Mental Health Problems in Adulthood: The Role of Adolescent Alcohol Use and Depression. J Stud Alcohol Drugs 2017; 77:464-72. [PMID: 27172579 DOI: 10.15288/jsad.2016.77.464] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This study tested a developmental model in which subtypes of childhood maltreatment were hypothesized to have direct and indirect effects on co-occurring depression, anxiety, and substance misuse in adulthood. Indirect effects involved adolescent alcohol use and depression, which were included as mediators in the tested models. METHOD This prospective longitudinal study (N = 332; 52.4% male) followed the participants from childhood (18 months to 6 years of age) to adulthood (31-41 years old, M = 36.21). Maltreatment subtypes included parent-reported physical and emotional abuse and child-reported sexual abuse. Adult outcomes included measures of substance misuse and mental health (i.e., depression and anxiety). Latent class analysis and structural equation models were used to identify classes of substance misuse and mental health co-occurrence and to test mediating effects of adolescent alcohol use and depression. RESULTS Three classes were identified: (a) low risk of substance misuse and low mental health symptoms, (b) moderate substance misuse risk and mild depression and anxiety, and (c) moderate substance misuse risk and moderate to high depression and anxiety. Structural models showed that effects of childhood sexual abuse were fully mediated by adolescent alcohol use and depression. Physical abuse increased adolescent depression but did not have direct or indirect effects on adult outcome classes. Emotional abuse had a direct effect on the adult classes. CONCLUSIONS Children exposed to severe emotional abuse are at higher risk for comorbid substance misuse, depression, and anxiety into their mid-30s, after taking into account evidence of alcohol use and depression during adolescence. Sexual and physical abuse have more proximal effects on adolescent alcohol use and depression, which then influence the risk of adult problems.
Collapse
Affiliation(s)
- Martie L Skinner
- Social Development Research Group, School of Social Work, University of Washington, Seattle, Washington
| | - Seunghye Hong
- Myron B. Thompson School of Social Work, University of Hawai'i at Mānoa, Honolulu, Hawaii
| | - Todd I Herrenkohl
- Social Development Research Group, School of Social Work, University of Washington, Seattle, Washington
| | - Eric C Brown
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami, Miami, Florida
| | - Jungeun Olivia Lee
- School of Social Work, University of Southern California, Los Angeles, California
| | - Hyunzee Jung
- Social Development Research Group, School of Social Work, University of Washington, Seattle, Washington
| |
Collapse
|
9
|
Pérez-San-Gregorio MÁ, Martín-Rodríguez A, Luque-Budia A, Conrad R. Concerns, Mental Health, and Quality of Life in Living Kidney Donation-Parent Donor Candidates Worry Less about Themselves. Front Psychol 2017; 8:564. [PMID: 28443056 PMCID: PMC5387064 DOI: 10.3389/fpsyg.2017.00564] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 03/27/2017] [Indexed: 01/10/2023] Open
Abstract
Even though the majority of living kidney donor candidates appear in good mental health and show few concerns little is known concerning the influence of the type of donor-recipient relationship on donor candidates' specific concerns with regard to kidney donation. 136 donor candidates at Virgen del Rocío University Hospital of Seville filled in the Scale of Concerns Regarding Living Kidney Donation of whom 105 donor candidates and their corresponding recipients (105 patients with End-Stage Renal Disease) were further evaluated with regard to mental health (Hospital Anxiety and Depression Scale, Beck Depression Inventory-II) and quality of life (SF-36 Health Survey). As hypothesized recipients scored higher on depression and lower on quality of life. Donor candidates intending to donate to their children were significantly less concerned about risks of donation for themselves compared to donor candidates donating to siblings. Our findings highlight the importance of the type of donor-recipient relationship to understand specific concerns of donor candidates and optimize psychosocial assessment and support. From an evolutionary perspective parents lack of concern about their own well-being can be seen as an altruistic behavior to increase children's fitness at the (potential) expense of their own fitness.
Collapse
Affiliation(s)
| | - Agustín Martín-Rodríguez
- Department of Personality, Assessment, and Psychological Treatment, University of SevilleSeville, Spain
| | - Asunción Luque-Budia
- Liaison Mental Health Services, University Hospital Virgen del RocíoSeville, Spain
| | - Rupert Conrad
- Department of Psychosomatic Medicine and Psychotherapy, University of BonnBonn, Germany
| |
Collapse
|
10
|
Strunk KK, Lane FC. The Beck Depression Inventory, Second Edition (BDI-II). MEASUREMENT AND EVALUATION IN COUNSELING AND DEVELOPMENT 2016. [DOI: 10.1177/0748175616664010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
11
|
Abstract
Two meta-analyses examined the factor structure of the Beck Depression Inventory-II (BDI-II). Study 1, which meta-analyzed 51 studies comprising 62 samples (N = 20,475) providing pattern matrices, determined that the two-factor solution comprising Cognitive and Somatic-Affective factors was supported for the full sample. The two-factor solution was also supported for subgroups of studies. As the factor structure varied somewhat between subgroups of studies, the strength of relationships between scale items and their underlying depressive symptoms varied. Hence, comparisons of mean BDI-II scores across subgroups can be misleading. Study 2 meta-analyzed 13 studies consisting of 16 samples (N = 5,128) providing covariance matrices among the 21 BDI-II items. The two-factor solution was again supported in Study 2. Nevertheless, the existence of a general depression factor was supported by the good fit of the one-factor model.
Collapse
|
12
|
Carlozzi NE, Miciura A, Migliore N, Dayalu P. Understanding the Outcomes Measures used in Huntington Disease Pharmacological Trials: A Systematic Review. J Huntingtons Dis 2014; 3:233-52. [PMID: 25300328 PMCID: PMC4217648 DOI: 10.3233/jhd-140115] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The identification of the gene mutation causing Huntington disease has raised hopes for new treatments to ease symptoms and slow functional decline. As such, there has been a push towards designing efficient pharmacological trials (i.e., drug trials), especially with regard to selecting outcomes measures that are both brief and sensitive to changes across the course of the disease, from subtle prodromal changes, to more severe end-stage changes. OBJECTIVES Recently, to aid in efficient development of new HD research studies, the National Institute of Neurological Disorders and Stroke (NINDS) published recommendations for measurement selection in HD. While these recommendations are helpful, many of the recommended measures have little published data in HD. As such, we conducted a systematic review of the literature to identify the most common outcomes measures used in HD clinical trials. METHODS Major medical databases, including PubMed, Embase, CINAHL, and the Cochrane Central Register of Controlled Trials, were used to identify peer-reviewed journal articles in English from 2001 through April 2013; 151 pharmacological trials were identified. RESULTS The majority of HD clinical trials employed clinician-reported outcomes measures (93%); patient reported outcome measures (11%) and observer reported outcome measures (3%) were used with much less frequency. CONCLUSIONS We provide a review of the most commonly used measures across these trials, compare these measures to the clinical recommendations made by the NINDS working groups, and provide recommendations for selecting measures for future clinical trials that meet the Food and Drug Administration standards.
Collapse
Affiliation(s)
- Noelle E Carlozzi
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - Angela Miciura
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - Nicholas Migliore
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - Praveen Dayalu
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
13
|
Wang YP, Gorenstein C. Psychometric properties of the Beck Depression Inventory-II: a comprehensive review. BRAZILIAN JOURNAL OF PSYCHIATRY 2013; 35:416-31. [DOI: 10.1590/1516-4446-2012-1048] [Citation(s) in RCA: 655] [Impact Index Per Article: 59.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Accepted: 02/13/2013] [Indexed: 02/05/2023]
|
14
|
Wang YP, Gorenstein C. Assessment of depression in medical patients: a systematic review of the utility of the Beck Depression Inventory-II. Clinics (Sao Paulo) 2013; 68:1274-87. [PMID: 24141845 PMCID: PMC3782729 DOI: 10.6061/clinics/2013(09)15] [Citation(s) in RCA: 167] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 05/02/2013] [Indexed: 11/27/2022] Open
Abstract
To perform a systematic review of the utility of the Beck Depression Inventory for detecting depression in medical settings, this article focuses on the revised version of the scale (Beck Depression Inventory-II), which was reformulated according to the DSM-IV criteria for major depression. We examined relevant investigations with the Beck Depression Inventory-II for measuring depression in medical settings to provide guidelines for practicing clinicians. Considering the inclusion and exclusion criteria seventy articles were retained. Validation studies of the Beck Depression Inventory-II, in both primary care and hospital settings, were found for clinics of cardiology, neurology, obstetrics, brain injury, nephrology, chronic pain, chronic fatigue, oncology, and infectious disease. The Beck Depression Inventory-II showed high reliability and good correlation with measures of depression and anxiety. Its threshold for detecting depression varied according to the type of patients, suggesting the need for adjusted cut-off points. The somatic and cognitive-affective dimension described the latent structure of the instrument. The Beck Depression Inventory-II can be easily adapted in most clinical conditions for detecting major depression and recommending an appropriate intervention. Although this scale represents a sound path for detecting depression in patients with medical conditions, the clinician should seek evidence for how to interpret the score before using the Beck Depression Inventory-II to make clinical decisions.
Collapse
Affiliation(s)
- Yuan-Pang Wang
- Department of Psychiatry (LIM-23), Medical School, University of São Paulo, São PauloSP, Brazil
| | | |
Collapse
|