慢性疼痛患者向けうつ病スクリーニングの精度を検証(Study validates accuracy of depression screening for people with chronic pain)

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2026-05-13 アリゾナ大学

アリゾナ大学の研究チームは、慢性疼痛患者に対するうつ病スクリーニング検査の有効性を検証し、一般的な評価手法がこの集団でも高い精度を持つことを確認した。慢性疼痛患者では、痛みに伴う疲労や睡眠障害などがうつ症状と重なり、正確な診断が難しいとされてきた。研究では、多数の慢性疼痛患者データを解析し、標準的なうつ病評価尺度が感度・特異度の両面で信頼性を持つことを示した。これにより、慢性疼痛診療における精神健康評価の重要性が再確認された。研究者らは、早期のうつ症状発見が治療成績や生活の質向上につながる可能性を指摘している。また、身体症状と精神症状を統合的に評価する医療アプローチの必要性も強調された。本研究は、慢性疼痛患者に対する精神医療支援の改善や、臨床現場でのスクリーニング普及促進に寄与すると期待されている。

慢性疼痛患者向けうつ病スクリーニングの精度を検証(Study validates accuracy of depression screening for people with chronic pain)
A new study found that a widely used depression screening questionnaire is accurate for people with and without chronic pain.Adobe Stock

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Do somatic symptoms bias depression screening? Reliability and equivalence of PHQ-8 in those with and without chronic pain: A nationally representative study of U.S. adults

Jennifer S. De La Rosa, Greg T. Chism, Katherine E. Herder, Chung Jung Mun, Rachel V. Aaron
Journal of Affective Disorders  Available online: 23 February 2026
DOI:https://doi.org/10.1016/j.jad.2026.121496

Highlights

  • Depression screening is not biased by overlapping symptoms in depression and chronic pain.
  • Interpretation of screening results in those with chronic pain is straightforward.
  • Those with chronic pain experience profound mental health disparities.
  • Mental health stigmas specific to the lived experience of chronic pain should be addressed.

Abstract

The 8-item Patient Health Questionnaire (PHQ-8) is implemented into clinical practice and scientific research worldwide. However, in the context of chronic pain (CP), depression screening could be confounded by overlapping somatic symptoms. Inaccurate attribution of CP symptoms to depression could lead to overestimation of depressive symptom severity or even artifactual inflation of depression prevalence estimates. We aimed to determine the reliability and equivalence of PHQ-8 in adults with and without CP. This nationally representative survey study examined data from the 2019 National Health Interview Survey. The final analytic sample contained (n = 30,983) U.S. adults who completed survey items on CP and the PHQ-8. Descriptives and visualizations were generated; reliability, cross-group equivalence, and measurement invariance were assessed. The PHQ-8 was reliable; measurement invariance and cross-group equivalence were observed at the configural, metric, and scalar levels; differential item functioning was not observed. No evidence consistent with overestimation of depression prevalence or severity in the contexts of CP or HICP was observed. The PHQ-8 is reliable and measures depressive symptoms equivalently in the context of CP, supporting the use of PHQ-8 to screen for depression in clinical practice, scientific research, and population health surveillance of adults with and without CP. CP is regularly observed to be associated with five to ten times greater prevalence of positive screens for clinically significant depressive symptoms. This study offers compelling evidence that this disparity reflects true differences in the prevalence of depression in those with chronic pain and is not attributable to measurement artifacts.

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