Comparison between the Beck Depression Inventory and psychiatric evaluation of distress in patients on long-term sick leave due to chronic musculoskeletal pain

Figures & data

Figure 1 Flow diagram 1.

Table 1 Mean and median values of the BDI scores for groups having different psychiatric diagnoses (DMS-IV-RT) in patients with long-term sick leave due to chronic musculoskeletal pain

Psychiatric diagnosis (number of patients)	BDI score (mean/median values)	Percentage of the total (%)
Depression (n = 40)	28/26*	17
Mild (n = 12)	20/20	33
Moderate to severe (n = 24)	29/29	6
Extreme depression (n = 4)	48/44
Other psychiatric diagnoses (n = 22)	24/23	31
No psychiatric illness (n = 9)	18/21	13
Total (n = 71)	26/23**	100

Notes:

* Comparisons between degrees of clinical depression: Kruskall–Wallis and median test, p < 0.005;

** Group comparisons: Kruskall–Wallis test, p < 0.01 (clinical depression and other psychiatric illness vs no psychiatric illness).

Abbreviation: BDI, Beck Depression Inventory.

Table 2 Comparisons between the BDI scores and the diagnosis of depression or other psychiatric illness according to the psychiatrist in patients with chronic musculoskeletal pain

Levels of depression according to the BDI cut-scores (% of all patients with and without depression, n = 71)	Psychiatric diagnoses (DMS-IV-RT; % of all patients with and without depression, n = 71)
Severe depression: BDI >30 points	Depression
n = 20 (28%)	n = 40 (56%)
Moderate depression: BDI 21–30 points
n = 19 (27%)
Mild depression: BDI 13–20 points	Other psychiatric diagnoses
n = 20 (28%)	n = 22 (31%)
Minimal depression: BDI < 13 points	No psychiatric diagnosis
n = 12 (17%)	n = 9 (13%)

Abbreviation: BDI, Beck Depression Inventory.

Table 3 The psychiatric diagnoses and the distribution of the BDI score for case 1 and case 2 among patients with chronic musculoskeletal pain

Psychiatric assessment	Case 1 Depression	No psychiatric illness	Case 2 Other psychiatric illness	No psychiatric illness
BDI cut-off	n = 40	n = 9	n = 22	n = 9
BDI ≥ 13	35 (72%)	5 (10%)	19 (61%)	5 (16%)
BDI < 13	5 (10%)	4 (8%)	3 (10%)	4 (13%)

Notes: Case 1: depression compared with no psychiatric illness; case 2: other psychiatric illness irrespective of depression compared with no psychiatric illness. The figures given are percentages of the total within the group.

Abbreviation: BDI, Beck Depression Inventory.

Table 4 Diagnostic analyses of the BDI scores and psychiatric evaluation in patients with chronic musculoskeletal pain

BDI cut-off point	Sensitivity (%)	LR (+)/LR (−)a	Percent agreement	Kappa (κ)b	McNemar test
Case 1
BDI ≥ 13	87.5	1.58/0.28	80.0	0.32*	2.6**
Case 2
BDI ≥ 13	86.0	1.55/0.31	74.0	0.33*	0.69**

Notes: Case 1: depression compared with no psychiatric illness (n = 49); case 2: other psychiatric illness irrespective of depression compared with no psychiatric illness (n = 31).

a LR (+) = sensitivity/1-specificity; LR (−) = 1-sensitivity/specificity;

b Cohen’s Kappa for dichotomous variables; McNemar’s test.

* Statistically significant p < 0.05;

** Statistically significant p > 0.05.

Abbreviation: BDI, Beck Depression Inventory.