Researchers report that the PHQ-8, a common eight-item depression questionnaire, performs equivalently for people with and without chronic pain. The paper, in the Journal of Affective Disorders, analyzed nearly 32,000 US adults from the 2019 National Health Interview Survey and applied data science techniques to assess measurement invariance — that is, whether the questionnaire functions without bias across groups.
The study found no evidence that shared symptoms such as sleep problems and fatigue artificially inflate depression screening scores for people living with chronic pain. Lead author Jennifer S. De La Rosa said, “Could pain symptoms artificially inflate depression screening scores among those with chronic pain? It’s a reasonable question, but it had not yet been definitively answered.”
The authors note clinical implications: positive depression screens are as reliable in patients with chronic pain as in others, so clinicians should offer mental health supports while discussing concerns sensitively. The paper cites earlier findings that one in five people with chronic pain have depression and that adults with chronic pain are more likely to experience anxiety and depression but access mental health care at lower rates. Coauthors come from the University of Arizona, Arizona State University, and Johns Hopkins School of Medicine, and the study received support from the National Institutes of Health. According to the CDC, about 64 million US adults experienced chronic pain in 2023.
Difficult words
- measurement invariance — whether a test works without bias across groups
- inflate — to make scores appear higher than they are
- clinician — a health professional who treats patientsclinicians
- bias — an unfair influence on results or decisions
- reliable — consistently accurate or dependable in results
- chronic pain — long-lasting pain that continues for months or years
Tip: hover, focus or tap highlighted words in the article to see quick definitions while you read or listen.
Discussion questions
- Why might adults with chronic pain access mental health care at lower rates, and what could clinicians do to improve access?
- How could the finding that the PHQ-8 performs equivalently change how clinicians assess depression in patients with chronic pain?
- What are the implications for public health given that about 64 million US adults experienced chronic pain in 2023?
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