Impressive Performance of a Self-Rating Scale for Depression

Abstract & commentary

Synopsis: The Beck Depression Inventory (BDI) is an adequately sensitive and specific self-rated instrument to detect patients with major depression.

Source: Lasa L, et al. J Affect Disord 2000;57:261-265.

This concise study from spain examined the sensitivity and specificity of the Beck Depression Inventory (BDI) in detecting the presence of major depression in the general population. Lasa and associates studied 1250 subjects between 18 and 64 years old, identified through census data. All individuals completed the short, self-rated BDI. Fifty-two cases had elevated BDI scores (a priori defined as greater than 12), as defined in previous published literature. Forty-four of these 52 subjects agreed to be interviewed. Thirty-two of the 44 subjects with BDI scores greater than 12 met criteria for major depression in a structured interview with a research psychiatrist. A random sample of 5% of the cohort who scored less than 13 on the BDI were also interviewed. None of these subjects with low BDI scores met criteria for major depression.

The statistical analysis of Lasa et al’s findings revealed an extremely high sensitivity and specificity for their cutoff value for the BDI. A low BDI (< 13) was 100% predictive of not being depressed.

Comment by Andrew L. Stoll, MD

In summary, this study examined the predictive value of the BDI for independently diagnosed major depression in the general population. The strong results suggest that the BDI is an adequately sensitive and specific self-rated instrument to detect patients with major depression. Because it is self-rated and requires little or no work from the clinician, the BDI may be a useful screening tool in a primary care practice, where detecting major depression has traditionally been a time-consuming and less than satisfactory process. (Dr. Stoll is Director, Psychopharmacology Research Laboratory, McLean Hospital, Belmont, MA.)