The Utility of the Beck Depression Inventory in the Evaluation of Chronic Pelvic Pain Patients

Abstract

Objective: The aim of this study to estimate if patients with chronic pelvic pain (CPP) and evidence of clinical depression suffer from a decreased prevalence of significant organic pelvic pathology when compared to euthymic CPP patients and patients undergoing laparoscopic tubal ligation. Design: In this observational cohort study (Canadian Task Force Classification II-2), 28 CPP and 30 tubal ligation patients were preoperatively administered the Beck Depression Inventory (BDI) and then assessed with diagnostic laparoscopy. Groups were then compared with respect to pelvic pathology and BDI scores. Measurements and Main Results: Patients with CPP had a greater overall rate of depressive comorbidity, with 57% (16/28) of the patients suffering from depression, based on our preoperative depression screen. In contrast, control patients suffered from depressive comorbidity only 10% (3/30) of the time. CPP patients had evidence of significant pathology 50% of the time, while asymptomatic tubal ligation patients demonstrated significant pathology 40% of the time. Subgroup analysis of CPP patients demonstrated that patients with CPP are equally likely to have abnormal pathology regardless of their depressive symptom scores. Conclusions: Consistent with prior studies, patients with CPP suffer from a greater prevalence of depression. Additionally, our study found no difference in the incidence of significant pelvic pathology in CPP patients with depression than those without. Consequently, the delay of diagnostic laparoscopy may hinder the timely diagnosis and treatment of CPP patients with evidence of clinical depression.