The psychometric properties of Beck Depression Inventory for adolescent depression in a primary-care paediatric setting in India

Abstract

BackgroundThere is increasing interest in identifying adolescents with depression in primary care settings by paediatricians in India. This article studied the diagnostic accuracy, reliability and validity of Beck Depression Inventory (BDI) while used by paediatricians in a primary care setting in India.Methods181 adolescents attending 3 schools were administered a back translated Tamil version of BDI by a paediatrician to evaluate its psychometric properties along with Children's Depression Rating Scale (CDRS-R) for convergent validity. Clinical diagnosis of depressive disorders, for reference standard, was based on ICD-10 interview by an independent psychiatrist who also administered the Impact of Event Scale (IES) for divergent validity. Appropriate analyses for validity and diagnostic accuracy both at the item and scale levels were conducted.ResultsA cut-off score of ≥ 5 (Sn = 90.9%, Sp = 17.6 %) for screening and cut-off score of ≥ 22 (Sn = 27.3%, Sp = 90%) for diagnostic utility is suggested. The 4 week test – retest reliability was good (r = 0.82). In addition to the adequate face and content validity, BDI has very good internal consistency (α = 0.96), high convergent validity with CDRS-R (r = 0.72; P = 0.001), and high discriminant validity with IES (r = 0.26; P = 0.23). There was a moderate concordance rate with the reference standard (54.5%) in identifying depression among the adolescents. Factor analysis replicated the 2-factor structure explaining 30.5 % of variance.ConclusionThe BDI proved to be a psychometrically sound measure for use by paediatricians in a primary care setting in India. The possibility of screening for depressive disorders through the use of BDI may be helpful in identifying probable cases of the disorder among adolescents.

Sample size requirements for the internal validation of psychiatric scales

“…The data simulation was performed using R software 2.6.2.; vectors ε j , f m and C were generated using the function rnorm and δ j using runif. (Bell et al, 1994;Fresan et al, 2005;Honey et al, 2003;Kay et al, 1990;Lancon et al, 1999;Lee et al, 2003;Lindenmayer et al, 2004;Loza et al, 2003;Lykouras et al, 2000;Salokangas et al, 2002;Villalta-Gil et al, 2006) 11 --1 8 -2 BPRS (Adachi et al, 2000;Harvey et al, 1996;Lachar et al, 2001;Ventura et al, 2000) 4 --2 1 1 -BAI (Beck, 1991;Chapman et al, 2009;Kabacoff et al, 1997;Steer et al, 1995;Steer et al, 1993) (Gabryelewicz et al, 2004;Galinowski et al, 1995;Lee et al, 2003;Parker et al, 2003;Serretti et al, 1999) 5 3 2 ----BDI (Basker et al, 2007;Bonicatto et al, 1998;Bonilla et al, 2004;Gorenstein et al, 1999;Grunebaum et al, 2005;Helm et al, 2003;Jo et al, 2007;Killgore, 1999;Munoz et al, 2007;Powell, 2003;Salamero et al, 1994;Shek, 1990;Steer et al, 1989;Uslu et al, 2008;Wang et al, 2005) …”

Academic stress and depression among adolescents: A cross-sectional study

“…Beck Depression Inventory (BDI) [5] a psychometrically sound measure for screening depression among adolescents [6], was administered to the Case group. BDI was used specifically to classify the these adolescents into minimal, mild, moderate and severe depression.…”

Prevalence of depression and its associated factors among medical students: a study using beck depression inventory

“…[8][9] This is a subjective scale and utilized for screening purpose, that needs to be further evaluated to confirm the diagnosis. We applied this scale to screen for depression based on self-report.…”