Purpose
The Beck Depression Inventory (BDI) is one of the most widely used screening instruments for
measuring the severity of depression in both adults and adolescents over the age of 13
(McDowell & Newell, 1996). The inventory is composed of items relating to depressive
symptoms such as:
Hopelessness and irritability
Cognitions (such as guilt or feelings of being punished)
Physical symptoms (such as fatigue, weight loss, and lack of interest in sex).
The BDI can be used, but is not limited to, persons with stroke.
In-Depth Review
Purpose of the measure
The Beck Depression Inventory (BDI) is one of the most widely used screening instruments for
measuring the severity of depression in both adults and adolescents over the age of 13
(McDowell & Newell, 1996). The inventory is composed of items relating to depressive
symptoms such as hopelessness and irritability, cognitions such as guilt or feelings of being
punished, as well as physical symptoms such as fatigue, weight loss, and lack of interest in sex.
The BDI can be used, but is not limited to, persons with stroke.
Available versions
There are two versions of the BDI
The original BDI, first published in 1961 and later revised in 1971 (BDI-IA) and the BDI-II, a
revised version of the BDI that was published in 1996, created to correspond with the updated
DSM-IV criteria for depression.
Features of the measure
Items:
– The original BDI
Contains 21 items and identifies symptoms and attitudes associated with depression. The
respondent must recall the relevance of each statement for today: mood, pessimism, sense of
failure, lack of satisfaction, guilt, sense of punishment, self-hate, self-accusations, self-punitive
wishes, crying spells, irritability, social withdrawal, indecisiveness, body image, work inhibition,
sleep disturbance, fatigability, loss of appetite, weight loss, somatic preoccupation, and loss of
libido.
– The BDI-IA
Same as the original BDI, but the respondent must recall the relevance of each statement based
on the previous week including today.
– The BDI-II
Contains 21 items and identifies symptoms and attitudes associated with depression. The BDI-II
dropped four items (Weight Loss, Body Image Change, Somatic Preoccupation, and Work
Difficulty) from the original BDI and replaced them with four new items (Agitation,
Worthlessness, Concentration Difficulty, and Loss of Energy). The respondent must recall, based
on the previous two weeks, the relevance of each statement relating to: sadness, pessimism, sense
of failure, loss of pleasure, guilt, expectation of punishment, dislike of self, self-accusation,
suicidal ideation, episodes of crying, irritability, social withdrawal, indecisiveness,
worthlessness, loss of energy, insomnia, irritability, loss of appetite, preoccupation, fatigue, and
loss of interest in sex (Beck & Steer, 1988).
Scoring:
– BDI scoring:
Each item is evaluated on a severity scale ranging from 0-3, with a total score ranging from 0-63
0-10 on the BDI is considered absent or minimal depression;
10-18 mild to moderate depression;
19-29 is moderate depression;
30-63 is severe depression.
– BDI-II scoring:
0-13 is considered none or minimal range depression;
14-19 mild depression;
20-28 moderate depression;
29-63 severe depression.
Subscales:
None typically reported.
Equipment:
Only a pencil and the test are needed.
Training:
Traditionally, the BDI was designed to be administered by a trained interviewer. Today however,
the BDI is commonly self-administered as it is short and simple to use. Patients must be able to
understand spoken or written language and have a fifth- to sixth-grade reading level to
adequately understand the questions (Groth-Marnat, 1990).
Time:
The BDI takes from 5-10 minutes to complete when self-administered, and 15 minutes to
complete when interviewer-administered (Beck & Steer, 1988; McDowell & Newell, 1996). The
questions are posed around a two-week period including today, as opposed to around the past
week as in the original BDI. Thus, in the early post-stroke period, the BDI may be an
inappropriate tool as the responses given in the early period are unlikely to provide a valid
estimate of depression.
Alternative forms of the BDI
The BDI-SF is a short form of the BDI and is composed of 13-items (Beck & Beck, 1972). The
BDI-SF appears to have a level of internal consistency (coefficient alphas) comparable to that of
the long form (Beck, Steer, & Garbin, 1988). Pearson product-moment correlation coefficients
between the BDI and the BDI-SF have ranged from 0.89 to 0.97 indicating that the short form is
an acceptable substitute for the long (Beck, Rial, & Rickets, 1974).
The BDI-FastScreen for medical patients (formerly known as BDI-Primary Care)is a 7-item
self-report inventory designed specifically for use as a screening tool in medical patients. The
BDI-FastScreen takes less than five minutes to complete and questions are posed around the past
two weeks including today. It is thought to be a clinically effective screen for identifying medical
inpatients who should be evaluated for depression, however, it has not been found to be as
sensitive a measure as the full BDI-II (Beck, Guth, & Steer, 1997; Sharp & Lipsky, 2002).
