This study compared the BDI-FS to the BDI-II in a sample of patients with chronic pain. The objectives were to: look at agreement between measures, determine BDI-FS cut-off scores, develop a conversion formula, consider the usefulness of the suicide ideation item and compare ability to detect clinical change. Phase I: Archival data from 1227 patients assessed for a pain management programme was analysed. The BDI-FS displayed good internal consistency (alpha=.839). ROC curve analysis showed good agreement between the BDI-II and FS and suggested a BDI-FS cut-off of four corresponded to the 19 cut-off recommended in the BDI-II manual. We recommend a cut-off of five to correspond to a BDI-II cut-off of 22 for pain clinic patients recommended by previous research. Regression suggested BDI-II score=(2.77 x BDI-FS score)+9.14. Our data support the clinical usefulness of the suicide ideation item in this population. Phase II: Archival data from 584 patients collected at baseline, following a 16 day pain management programme and at 6 months follow-up, was analysed. Effect sizes indicated equivalent sensitivity to clinical change. The BDI-FS showed good psychometric properties, strong agreement with the BDI-II and equal ability to detect clinical change in a pain clinic population. The BDI-FS has the practical advantages of faster administration and reduced patient burden.