What is the Beck Depression Inventory (BDI)?

Introduction

The Beck Depression Inventory (BDI) is an assessment used to measure the presence and severity of
depression. It was developed in 1972 by psychiatrist Aaron T. Beck, who earned his PhD in psychiatry from Yale University in 1946. He became interested in psychoanalysis and cognition during his residency in neurology. Beck was the assistant chief of neuropsychology at Valley Forge General Hospital during the Korean War. He graduated from the Philadelphia Psychoanalytic Institute in 1956 and began research to validate psychoanalytic theories. However, his research did not support his hypotheses, so he began to develop cognitive therapy for depression. He developed several depression screening tests, including the Beck Depression Inventory.

The Nature of Depression

Depression is a mental state characterized by extreme feelings of sadness, dejection, and lack of self-esteem. Depression affects men and women, young and old, of all races and socioeconomic statuses. According to statistics from the Substance Abuse and Mental Health Services Administration (SAMHSA) combined data from the 2008 to 2012 National Surveys on Drug Use and Health, approximately 15.2 million adults in the United States experience a major depressive episode (MDE) each year. Of the respondents surveyed from 2008 to 2012, 38.3 percent of adults who had an MDE within the past year did not talk to a professional about it. Of those who did seek professional help, 48 percent talked to a health professional such as a general practitioner or family doctor, while 10.7 percent talked to a health professional and an alternative service professional, and 2.9 percent talked to an alternative service professional only. In 2012, the World Health Organization reported that more than 350 million people of all ages experienced depression, with 1 million suicide deaths reported annually. In 2001, the World Health Organization (WHO) asserted that by the year 2020, depression would be the second greatest cause of premature death in the world.

Depression is a common and costly mental health problem, seen frequently in primary-care settings. Between 5 and 13 percent of those seen in a physician’s office have a major depressive disorder. Depression is more prevalent in the young, female, single, divorced, separated, and seriously ill and those with a history of depression.

The National Institute of Mental Health reports that in 2002 the annual total direct and indirect costs of serious mental illness, including depression, were about $317 billion; in July 2013 the New York Times estimated that these annual costs approached $500 billion. According to a study published in May 2010 by the Journal of General Internal Medicine, 25 percent of people in the United States with major depression are not diagnosed with the condition, and fewer than 50 percent receive treatment for it. Therefore, it has been proposed that routine depression screening may be instrumental in early identification and improved treatment of depressive disorders. Side effects from medications, medical conditions such as infection, endocrine disorders, vitamin deficiencies, and alcohol or drug abuse can cause symptoms of depression. The possibility of physical causes of depressive symptoms can be ruled out through a physical examination, medical history, and blood tests. If a physical cause for depression is excluded, a psychological evaluation, called a depression screening, should be performed. This screening includes a history of when symptoms started, the length of time they have been present, the severity of symptoms, whether such symptoms have been experienced previously, the methods of treatment, and whether any family members have had a depressive disorder and, if so, what methods were used to treat them.

The
Diagnostic and Statistical Manual of Mental Disorders: DSM-5 (5th ed., 2013) is the standard for diagnosing depression. DSM-5 criteria for a major depressive episode, require a depressed mood or loss of interest or pleasure, in addition to five or more of the following symptoms during a single two-week period that are a change from previous functioning: lack of energy, thoughts of death or suicide, sleep disturbances, changes in appetite, feelings of guilt and worthlessness, poor concentration, and difficulty making decisions. Depression screening questionnaires assist in predicting an individual’s risk of depression.

Self-Rating with the BDI

The BDI is a self-rating scale that measures the severity of depression and can be used to assess the progress of treatment. It consists of twenty-one items and is designed for multiple administrations. Modified, shorter forms of the BDI have been designed to allow primary care providers to screen for depression. Each symptom of depression is scored on a scale of 0 for minimal to 3 for severe. Questions address sadness, hopelessness, past failure, guilt, punishment, self-dislike, self-blame, suicidal thoughts, crying, agitation, loss of interest in activities, indecisiveness, worthlessness, loss of energy, insomnia, irritability, decreased appetite, diminished concentration, fatigue, and lack of interest in sex. A score less than 15 indicates mild depression, scores from 15 to 30 indicate moderate depression, and a score greater than 30 indicates severe depression.

Bibliography

American Medical Association, ed. Essential Guide to Depression. New York: Pocket, 2000. Print.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: APA, 2013. Print.

American Psychological Association. "Beck Depression Inventory (BDI)." American Psychological Association. American Psychological Association, 2014. Web. 25 Feb. 2014.

Greden, J. “Treatment of Recurrent Depression.” In Review of Psychiatry. Ed. J. Oldham and M. Riba. Vol. 20. Washington, DC: American Psychiatric P, 2001. Print.

Greist, J., and J. Jefferson. Depression and Its Treatment. 2d ed. New York: Warner, 1994. Print.

Moyer, Christine S. "Depression Often Undiagnosed, As Symptoms Vary among Patients." American Medical News. American Medical Association, 8 June 2010. Web. 25 Feb. 2014.

National Institute of Mental Health. "Major Depressive Order among Adults." National Institute of Mental Health. National Institutes of Health, n.d. Web. 25 Feb. 2014.

Rampel, Catherine. "The Half-Trillion-Dollar Depression." New York Times. New York Times, 2 July 2013. Web. 25 Feb. 2014.

Scholten, Amy. "Depression." Health Library. Health Library, 30 Sept. 2013. Web. 25 Feb. 2014.

Substance Abuse and Mental Health Services Administration. "More than One Third of Adults with Major Depressive Episode Did Not Talk to a Professional." NSDUH Report 20 Feb. 2014. Digital file.

World Health Organization. "Depression: Fact Sheet No. 369." World Health Organization Media Centre. WHO, Oct. 2012. Web. 25 Feb. 2014.