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  Measure Details
  
General Information
Measure Name: The Beck Depression Inventory
Measure Type: Multi-item Scale
Construct: Depression
Primary Content Area: Mental Health
Secondary Content Area:
Brief Description: There are three versions of the BDI. The original 1961 instrument was revised in 1978, and revised again in 1996 to form the BDI-II (1). The modifications brought the instrument in line with DSM-IV diagnostic criteria and responded to other criticisms of the instrument. As with the 1978 revision, many of the 1996 changes related to the response categories, but changes were also made to four items. The revised version is available through the Psychological Corporation, but copyright forbids its reproduction here. However, copies can be found on hte Web, for example, by searching for a phrase such as "I do not feel sad." The BDI evaluates 21 symptoms of depression, 15 of which cover emotions, four cover behavioral changes, and six somatic symptoms. Each symptom is rated on a four-point intensity scale and scores are added together to give a total ranging from 0 to 63; higher scores represent more severe depression. Of the 21 items, 13 from an abbreviated version, as indicated by asterisks in the following list. The 21 items cover sadness,* pessimism,* past failure,* loss of pleasure,* guilty feelings, * punishment feelings, self-dislike,* self-criticism, suicicidal thoughts or wishes, * crying, agitation, loss of interest, *indecisiveness, worthlessness, *loss of energy, *changes in sleeping patterns, irritability,* changes in appetite, * difficulty concentrating, tiredness or fatigue, and loss of interest in sex (1, Table 1.1). The reading level of the revised version is tha tof a fifth-or sixth-grade student (4, p81). Most of the validation of the BDI was undertaken on the earlier versions of the scale, although some information has become available on the 1996 revision. The BDI was originally administered by a trained interviewer, while the patient read a copy (2, p562); it is more commonly self-administered now, taking five to ten minutes. Administration instructions are in the manual (1), and in the Appendix of Becks' book (5, pp336-337). If the respondent selects more than one statement in any group, the higher value is recorded; if his feelings lie between two alternatives, the one tha tis closer is scored. Computerized forms of the BDI are available (4, p80). Beck warns against rigid adherence to set cutting-points; these should be chosen according to the application. The following guidelines are commonly given: Scores of less than 10 indicate no or minimal depression, 10 to 18 indciate mild-to-moderate depression, 19 to 29 indicate moderate-to-severe depression, and scores of 30 or more indicate severe depression (4, p79). Moran and Lambert suggested that scores of 10 to 15 indicate mild, and 16 to 19 indicate moderate depression (7, p270). For pscyhiatric patients, a screening cutting-point of 12/13 is suitable, whereas 9/10 is appropriate in screening nonpsychiatric medical patients (6, p163). Furhter discussion of cutting-points for the earlier versions of the BDI was given by Kendall et al. (8). Scores on the BDI-II tend to be about three points higher than the BDI-I (1, p 25). For the BDI-II, scores of zero to 13 indicate minimal depression; 14 to 19 indicate mild depression; 20 to 28 moderate, and scores of 29 to 63 severe (1, p11). If a single cutting-point is required, 12/13 suggests dysphoria and 19/20 suggests dysphoria or depression (depending on the diagnostic criteria being used) (9, p85).
Keywords: BDI, depression, sadness, affective disorders
Target Population: Clinically depressed patients
Mode of Administration: Self-administered, Proxy, Face-to-face, Web
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Source Measure: No source measure has been specified.
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(Last Updated: 11/3/2010 4:34:53 PM by Terry Koenig)


  Comments & Ratings (2 comments)
  
BDI- length of scale, 4/6/2011 10:37:58 AM
By Jeffery Dusek, Abbott Northwestern Hospital, Allina Health
I agree with William Sieber that the length of the BDI-II for use in primary care and EHR. Furthermore, some of the questions related to sexual function are often skipped by research participants and may likely raise concerns if used broadly in an EHR.
limitations in primary care, 1/31/2011 10:55:38 AM
By William Sieber, UC San Diego
We began using the BDI in our family medicine clinics but received significant 'push back' from patients as to its length. We continue to use it if we need a secondary measure of outcomes as it is more detailed than the PHQ-9, which we use universally for patients referred to our collaborative care program.