The depressing truth about depression scales for people with chronic invisible illness, by CL Pederson, BM Wagner

Research conclusions: 

People with chronic invisible illnesses like POTS, CFS/ME, EDS, MCAS, and fibromyalgia have numerous and often severe somatic symptoms related to their illness that may over-inflate their depression scores on many common screening instruments. This leads to the possible over-diagnosis of depression in this community, further hindering individuals with chronic invisible illness when seeking treatment.

Research abstract

Background

Depression screening instruments are commonly used in research and the clinic.

Aim:

This study seeks to determine whether several common depression scales might be contaminated by somatic symptoms, thus overestimating depression in people with chronic invisible illness.

Method:

685 chronically ill women with postural orthostatic tachycardia syndrome, chronic fatigue syndrome/myalgic encephalomyelitis, mast cell activation syndrome, Ehlers-Danlos syndrome and/or fibromyalgia took the Beck Depression Inventory-II (BDI-II). For a broader look at major self-report scales that assess depression in adults, we also investigated seven additional instruments listed on the American Psychological Association webpage.

Results:

In this sample, 38.5% appeared to have major depression as measured by the BDI-II, but this number decreased to 8% when somatic symptoms were removed. Further, there was a 31.2% increase in the number of participants in the minimal depression category of the BDI-II-Mood.

Finally, 75% of the adult depression scales that we assessed had at least 40% of the score related to somatic symptoms.

Conclusion:

Care must be taken when assessing depression in people with chronic invisible illnesses to prevent artificial over-inflation of scores based on somatic complaints.

Study location:

Journal of Health Science & Education Vol 6, #1, p 223, July 11, 2022