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Evidence summaries

Beck as a Screening Method in Severe Depression, Dysthymia and other Affective Disorders of Adolescents

The sensitivity and specificity of the BDI questionnaire appears to be about 80% in detecting severe depression, dysthymia and affective disorders. Level of evidence: "B"

The 21-item Beck questionnaire was presented to a population sample of adolescents (n = 1704) 1. Depression and other psychiatric disturbances were diagnosed in a semistructured psyhiatric interview. In diagnosing severe depression (DSM-III-R) the specificity of the test was 81% and sensitivity was 84%, LR 4.4. For dysthymia the sensitivity of the test was 89% and specificity was 80%, LR = 3.0. For all affective disorders the sensitivity was 83% and specificity was 81%, LR = 4.4. On the basis of an ROC analysis the optimal limit score was 11 for girls and 15 for boys.

The utility of the Beck Depression Inventory (BDI) for differentiating adolescents with depressive disorders from adolescents with non affective psychiatric disorders was examined using a sample of 93 psychiatric outpatients and 26 inpatients 2. The Diagnostic Interview for Children and Adolescents (DICA) was administered to establish the patients' diagnosis. Psychiatric diagnoses were made by experienced clinicians who used all available information on the patient. The BDI scores discriminated between patients with depressive disorders and patients with non affective psychiatric disorders. The classification accuracy of the instrument was 75% at thresholds of 11 and 16 on the scale.

The utility of the Beck Depression Inventory (BDI) for identifying Major Depressive Episode was assessed with two samples of adolescents, 65 psychiatric hospital inpatients and 49 secondary school students 3. Diagnoses based on the Child Assessment Schedule served as criteria. With the school sample, a BDI screening score of 16 resulted in 100% sensitivity and 93.2% specificity. For the inpatient sample, a cutoff of 11 yielded a sensitivity of 81.5% and specificity of 52.6%.

    References

    • Roberts RE, Lewinsohn PM, Seeley JR. Screening for adolescent depression: a comparison of depression scales. J Am Acad Child Adolesc Psychiatry 1991 Jan;30(1):58-66. [PubMed]
    • Marton P, Churchard M, Kutcher S, Korenblum M. Diagnostic utility of the Beck Depression Inventory with adolescent psychiatric outpatients and inpatients. Can J Psychiatry 1991 Aug;36(6):428-31. [PubMed]
    • Barrera M Jr, Garrison-Jones CV. Properties of the Beck Depression Inventory as a screening instrument for adolescent depression. J Abnorm Child Psychol 1988 Jun;16(3):263-73. [PubMed]

Primary/Secondary Keywords