The Beck Depression Inventory (BDI-II) and a single screening question as screening tools for depressive disorder in Dutch advanced cancer patients. The optimal cut-off point of the BDI-II was 16 with a sensitivity of 90% and a specificity of 69%. The single screening question showed a sensitivity of 50% and a specificity of 94%. The BDI-II seems an adequate screening tool for a depressive disorder in advanced cancer patients. The sensitivity of a single screening question is poor.
Beck Depression Inventory (BDI) The Beck Depression Inventory (BDI) is a self administered 21item self report scale, presented in multiple choice format, designed to detect presence of depression in adolescents and adults, and to measure characteristic attitudes and symptoms of depression independent of any particular theoretical bias.
Beck Depression Inventory (BDI) The Beck Depression Inventory (BDI) is a commonly used instrument for quantifying levels of depression. The scale for the BDI was originally created by patients’ descriptions of their symptoms – mood, pessimism, sense of failure, self-dissatisfaction, guilt, suicidal ideas, crying.
Description of Measure: The Beck Depression Inventory (BDI) is a 21-item, self-report rating inventory that measures characteristic attitudes and symptoms of depression (Beck, et al., 1961). The BDI has been developed in different forms, including several computerized forms, a card form (May.
Beck Depression Inventory (BDI) The Beck Depression Inventory (BDI) is a commonly used instrument for quantifying levels of depression. The scale for the BDI was originally created by patients’ descriptions of their symptoms – mood, pessimism, sense of failure, self-dissatisfaction, guilt, suicidal ideas, crying.
The Beck Depression Inventory (BDI) is a 21-item self-reporting questionnaire for evaluating the severity of depression in normal and psychiatric populations [1,2]. Developed by Beck et al. in 1961, it relied on the theory of negative cognitive distortions as central to depression [3]. It underwent revisions in 1978: the BDI-IA and 1996 and the BDI-II, both copyrighted [4]. The BDI-II does not rely on any particular theory of depression and the questionnaire has been translated into several languages. A shorter version of the questionnaire, the BDI Fast Screen for Medical Patients (BDI-FS), is available for primary care use. That version contains seven self-reported items each corresponding to a major depressive symptom in the preceding 2 weeks.
Description
The questionnaire was developed from clinical observations of attitudes and symptoms occurring frequently in depressed psychiatric patients and infrequently in non-depressed psychiatric patients [5]. Twenty-one items were consolidated from those observations and ranked 0–3 for severity. The questionnaire is commonly self-administered although initially designed to be administered by trained interviewers [3]. Self-administration takes 5–10min. The recall period for the BDI-II is 2 weeks for (major depressive symptoms) as operationalized in the fourth edition of Diagnostic and Statistical Manual (DSM-IV).
Items
The BDI-II contains 21 items on a 4-point scale from 0 (symptom absent) to 3 (severe symptoms). Anxiety symptoms are not assessed but affective, cognitive, somatic and vegetative symptoms are covered, reflecting the DSM-IV criteria for major depression. Scoring is achieved by adding the highest ratings for all 21 items. The minimum score is 0 and maximum score is 63. Higher scores indicate greater symptom severity. In non-clinical populations, scores above 20 indicate depression [6]. In those diagnosed with depression, scores of 0–13 indicate minimal depression, 14–19 (mild depression), 20–28 (moderate depression) and 29–63 (severe depression) [4].
Validity
Content validity of the BDI-II has improved following item replacements and rewording to reflect DSM-IV criteria for major depressive disorders. Mean correlation coefficients of 0.72 and 0.60 have been found between clinical ratings of depression and the BDI for psychiatric and non-psychiatric populations [3]. Construct validity is high for the medical symptoms measured by the questionnaire, α = 0.92 for psychiatric outpatients and 0.93 for college students [7]. High concurrent validities have been demonstrated between the questionnaire and other measures of depression such as the Minnesota Multiphasic Personality Inventory-D, r = 0.77 [3]. Criterion validity of the BDI-II is positively correlated with the Hamilton Depression Rating Scale (r = 0.71) with a high 1 week test-retest reliability r = 0.93 (suggesting robustness against daily variations in mood) and an internal consistency of α = 91 [4].
Key research
A Brazilian study (n = 1555) measured specific aspects of depression and found that the BDI discriminated highly for depressive symptomatology [8]. A chronic pain study (n = 1227) reported strong agreement between the BDI-FS and BDI-II with equal ability at detecting clinical change [9]. A coronary artery disease study (n = 804) found the BDI-II to be a better screening tool in predicting major mood disorders [10].
Availability and clinical use
The BDI-II is copyrighted. The rights are held by Harcourt Assessment Incorporated (Pearson Education plc), under contract from the author. A fee is required for the manual and record forms. This limits availability. In occupational health, the BDI-II can be used as a screening tool to detect depression in normal populations or as a tool to assess symptom severity in clinical populations.
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