Assessing Persons With Human Immunodeficiency Virus (HIV) Infection Using the Beck Depression Inventory: Disease Processes and Other Potential Confounds

Abstract

Symptoms of Human Immunodeficiency Virus (HIV) infection and somatic symptoms of depression overlap, confounding clinical assessments of persons with HIV infection. This research examined the extent of this confounding. In Study 1, 71 persons with HIV infection demonstrated high rates of depression on the Beck Depression Inventory (BDI). However, depression scores correlated with symptoms of HIV infection. In Study 2, 63 persons with HIV infection also demonstrated high rates of depression on the BDI, and depression was again related to symptoms of HIV disease; specifically, persistent fatigue, diarrhea, night sweats, and muscle aches. Principal component factor analyses demonstrated that somatic symptoms of depression were closely associated with number of Acquired Immunodeficiency Syndrome diagnoses, number of HIV-related symptoms, and inversely related to number of T-helper cells. In contrast, cognitive-affective depression was most closely related to anxiety, hypochondriasis, and number of months since tested HIV positive. Results support the conclusion that depression scores require differential interpretations at different stages of HIV disease and that persons who have experienced HIV-related symptoms only be assessed for depression using instruments void of somatic symptoms.

HIV in South Africa - depression and CD4 count

“…According to Svanborg and Aberg 4 the BDI is the most often used self-rating instrument for depressive symptoms and when compared with a self-rating version of the Montgomery Asberg Depression Rating Scale (MADRS-S), was found to be equivalent. Similar findings were found by Kalichman et al 5 and Cockram et al 6 when comparing with other rating scales.…”

Mediating roles of medication–taking self-efficacy and depressive symptoms on self-reported medication adherence in persons with HIV: A questionnaire survey

“…Scores ranging from 14 to19 and 20 to 28 indicate mild and moderate levels of depressive symptoms, respectively. The Cronbach's alpha for the BDI-II was .92 in a study using 500 psychiatric outpatients (Kalichman et al, 1995). In this study, the Cronbach's alpha for the BDI-II was .91, and the Cronbach's alphas for the cognitive, affective, and somatic subscales were .85, .74, and .83, respectively.…”

Alcohol Use, Depressive Symptoms and the Receipt of Antiretroviral Therapy in Southwest Uganda

“…Individuals who scored above the standard cut-off of 1.75 were classified as having depressive symptoms. Evidence suggests that the somatic measures in depression diagnostics may inflate depression scores among persons with HIV infection (Kalichman et al 1995), and it has, therefore, been suggested that such somatic measures be removed to prevent the overestimation of depressive symptoms among this population (Kalichman et al 2000). Hence, in this study we included only the affective measures of the DSHSCL when calculating the score and categorizing those as having or not having depressive symptoms.…”