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Sixty male and 60 female chronic pain patients were assessed on depression and preferred strategies for coping with depression upon admission and discharge from a multidisciplinary pain clinic. A significant number of patients were classified as dysphoric (45%) or depressed (35.8%). Patients' depression scores (BDI, MMPI-D) were positively correlated with self-blame/escape and negatively correlated with social support. During participation in the pain program, patients' BDI scores decreased and their preferred depression coping strategies became more adaptive. Depression coping strategies contributed significant variance over demographics and depression in predicting rehabilitation outcome. These results supported a cognitive-behavioral mediation model for understanding the relation between depression and chronic pain.