Beck Depression Inventory

The Beck Depression Inventory (BDI) and the second edition, the Beck Depression Inventory-II (BDI-II), are depression screening instruments published by the Psychological Corporation (http://www.harcourtassessment.com). The BDI-II is a 21-item self-report instrument (approximate administration time: 5–10 minutes) used to detect and estimate the overall severity of depression in adolescents and adults aged 13 years and older. The instrument can be administered orally as well as in group settings to clinical and normal patient populations. Symptoms of depression are evaluated according to criteria set forth in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (4th ed.).

The original BDI, developed in 1961, was based on the clinical observations of Dr. Aaron T. Beck and his associates and the typical verbal descriptions reported by depressed psychiatric patients. Representative depressive attitudes and symptoms were consolidated into 21 items read aloud to patients by trained interviewers. The inventory underwent revisions in 1971 at the Center for Cognitive Therapy, University of Pennsylvania, and the amended version, the BDI-IA, was copyrighted in 1978 and published in 1979. In the original version, respondents were instructed to rate various domains relating to their mood “right now,” whereas in the revised version, instructions asked for mood ratings for the “past week, including today.” The most significant revision of the BDI took place in 1996. This edition, the BDI-II, instructs respondents to provide ratings for the past two weeks. Recently, the BDI-FastScreen, a 7-item self-report measure, has been introduced for use with medical patients.

Each BDI-II item represents a particular symptom of depression: sadness, pessimism, past failure, loss of pleasure, guilty feelings, punishment feelings, self-dislike, self-criticalness, suicidal thoughts or wishes, crying, agitation, loss of interest, indecisiveness, worthlessness, loss of energy, changes in sleeping pattern, irritability, changes in appetite, concentration difficulty, tiredness or fatigue, and loss of interest in sex. Four statements in order of severity are presented to the patient for each item and rated on a 4-point scale ranging from 0 to 3. A total depression score is obtained by summing the ratings for the responses to all 21 items. The suggested cutoff scores are 0–13, minimal depression; 14–19, mild; 20–28, moderate; and 29–63, severe.

During the past four decades, the BDI has been used extensively for clinical as well as research purposes and translated into more than 25 languages. In clinical settings, the BDI is often an important component of a comprehensive psychiatric evaluation, and it is used to monitor treatment progress. In empirical studies, the instrument is commonly selected as an outcome measure to demonstrate treatment efficacy. The psychometric characteristics of the BDI-II have been established in groups of college students and psychiatric outpatients.