Does question order skew depression scores in chronic illness?

This study investigated whether the order of questions in a standard depression survey affects how people with scleroderma (systemic sclerosis) report physical symptoms like fatigue and sleep problems. Researchers wanted to know if patients score these symptoms differently when they are aware the questions are part of a depression assessment versus when they are not. Over 850 participants from an international scleroderma network were randomly assigned to take the survey with questions in the standard order or with the physical symptom questions asked first and separately.