Screening Test for Depression Using the SF-36 Health Survey in Patients with Chronic Musculoskeletal Pain

ABSTRACT

OBJECTIVE: To evaluate the usefulness of the mental component summary (MCS) from the short form 36-item health survey (SF-36) as a screening test for depression in patients with chronic musculoskeletal pain and identify the optimal cut-off value that predicts a positive depression score measured by the center for epidemiological study depression survey (CES-D). METHOD: This study was designed as a questionnaire survey. 502 patients who visited our outpatient clinics due to chronic musculoskeletal pain were evaluated. They completed the SF-36 and the CES-D. The correlation between the MCS score from the SF-36 and the CES-D was identified, and also the cut-off value of the MCS score was determined with ROC curves used the CES-D as the standard measure for depression. The MCS scores were compared according to age, sex, duration of diseases, diagnosis, and the presence of depression. RESULTS: The mean overall score of CES-D and the MCS score were 17.5+/-10.2, 52.2+/-16.4 respectively. The MCS scores negatively correlated with the CES-D (gamma=-0.879, p0.05). However, patients with depression had significantly lower MCS scores than patients without depression (p<0.05). The cut-off value was 42.4 with 88.1% of sensitivity and 92.6% of specificity. CONCLUSION: The MCS scores would be useful screening test for depression with cut-off value of 42.4 that predicts the closest result of the CES-D.