To assess the level of depression using the Beck Depression Inventory.
A mood disorder is a pattern of illness due to an abnormal mood. It’s a pervasive distortion of one’s emotional state. Nearly every patient who has a mood disorder experiences the “lows” of depression at some time, but some may also have the “highs” of mania. Many, but not all, mood disorders are diagnosed on the basis of a mood episode.
Broadly speaking, emotions can be described as two main types:
- Affect, which is a short-lived emotional response to an idea or an event, and
- Mood, which is a sustained and pervasive emotional response which colors the whole psychic life.
Mood disorders are diverse in nature, as is illustrated by the many types of depression recognized in the DSM-5 that we will discuss. Nevertheless, in all mood disorders (formerly called affective disorders), extremes of emotion or affect—soaring elation or deep depression—dominate the clinical picture. Other symptoms are also present, but the abnormal mood is the defining feature.
The two key moods involved in mood disorders are mania, often characterized by intense and unrealistic feelings of excitement and euphoria, and depression, which usually involves feelings of extraordinary sadness and dejection. Some people with mood disorders experience only time periods or episodes characterized by depressed moods. However, other people experience manic episodes at certain time points and depressive episodes at other time points. Normal mood states can occur between both types of episodes.
Bipolar I disorder is distinguished from major depressive disorder by the presence of mania. A mixed episode is characterized by symptoms of both full-blown manic and major depressive episodes for at least 1 week, whether the symptoms are intermixed or alternate rapidly every few days. Such cases were once thought to be relatively rare but have increasingly been recognized as relatively common (e.g., Cassidy et al., 1998; Goodwin & Jamison, 2007).
Indeed Goodwin & Jamison’s (2007) review of 18 studies reported that an average of 28 percent of bipolar patients at least occasionally experiences mixed states. Moreover, many patients in a manic episode have some symptoms of depressed mood, anxiety, guilt, and suicidal thoughts, even if these are not severe enough to qualify as a mixed episode.
Bipolar II: In this, the person does not experience full-blown manic (or mixed) episodes but has experienced clear-cut hypomanic episodes as well as major depressive episodes (Akiskal & Benazzi, 2005). Bipolar II disorder is equally or somewhat more common than bipolar I disorder, and, when combined, estimates are that about 2 to 3 percent of the U.S. population will suffer from one or the other disorder (e.g., Kessler et al., 2007; Kupfer, 2005). Bipolar II disorder evolves into bipolar I disorder in only about 5 to 15 percent of cases, suggesting that they are distinct forms of the disorder (Coryell et.al., 1995; Goodwin & Jamison, 2007).
Recently, a subthreshold form of bipolar II disorder has also been recognized as careful study has revealed that as many as 40 percent of individuals diagnosed with unipolar MDD have a similar number of hypomanic symptoms, although not with a sufficient number or duration to qualify for a full-blown hypomanic episode (Zimmerman et.al., 2009). Along with related findings, such results are leading researchers and clinicians to recognize that unipolar MDD is a far more heterogeneous category than previously recognized.
Beck’s Depression Inventory
Beck Depression Inventory (BDI) is 21 items assessing depression severity in normal and psychiatric populations. It is self-reported by participants. It was developed by Aaron T. Beck in 1961. In it, negative cognitive distortions were a central aspect of depression. It was revised in 1978 with the BDI-IA and 1996 with the BDI-II, both copyrighted. BDI-II does not rely on any particular theory of depression, and it is available in a variety of languages. A short version of the BDI questionnaire for medical patients, called the BDI Fast Screen (BDI-FS), is available for use in primary care. It includes seven self-reported items, each corresponding to a major depressive symptom in the past two weeks.
From clinical observations, the questionnaire was designed to measure attitudes and symptoms that appear frequently in depressed patients and rarely in non-depressed patients. A total of 21 items were analyzed from these observations and ranked 0–3 for severity. Most often, the questionnaire is self-administered but the questionnaire was originally designed to be administered by trained interviewers. A questionnaire can be self-administered in 5 to 10 minutes. A recall period is 2 weeks for the BDI-II (major depressive symptoms), as operationalized by the fourth edition of the Diagnostic and Statistical Manual (DSM-IV).
Validity and Reliability
The BDI test is widely known and tested for its validity in content, concurrent, and construct. According to the BDI concurrent validity analysis, it is highly congruent with other depression instruments, such as Minnesota Multiphasic Personality Inventory and Hamilton Depression Scale. A correlation of 0.77 was found between BDI and other depression instruments. Medical symptoms that the BDI measures also have high construct validity. According to Beck, outpatient samples had an alpha of .92, and college students had an alpha of .93. BDI-II was correlated with Hamilton Depression Rating Scale (r = 0.71), had one-week test-retest reliability of 0.93, and internal consistency *=0.91.
Items and scoring
There are 21 items in the BDI-II on a 4-point scale from 0 (no symptoms) to 3 (severe symptoms). In line with the DSM-IV criteria for major depression, anxiety symptoms are excluded but cognitive, somatic, and vegetative symptoms are assessed. Scores are calculated by adding all 21 items with the highest ratings. A minimum score is zero, and a maximum score is 63. A higher score indicates more severity.
Availability and clinical use
Copyright is reserved for the BDI-II. The rights are owned by Harcourt Assessment Incorporated (Pearson Education plc), by contract with the author. There is a charge for the record forms and the manual. Access to them is therefore limited. The BDI-II can be used in occupational health as a screening tool to detect depression in normal populations as well as to assess symptom severity in clinical populations.
TOOL USED: The Beck Depression Inventory (BDI) is a 21-item, self-report rating inventory that measures characteristic attitudes and symptoms of depression The BDI approximately takes 10 minutes to complete (Beck, et al., 1961).
Step 1: Rapport was formed with the subject before giving the instructions.
Step 2: The subject was provided with a copy of Beck’s Depression Inventory and a pencil.
Step 3: The subject was told to read the statements carefully and mark the most suitable one.
Step 4: The subject was helped if any confusion was there regarding the statements.
Step 5: The conduction was done properly in time and inventory was taken back after the subject completed the test.
Step 6: The scoring was done on the basis of norms of the inventory.
The subject was able to complete the test and obtained a score of 1 for questions 6, 8, 12, 14, and 15 and 2 for questions 20 and 21. And 0 for the rest of the questions. The Total score obtained is 9. The score of the participant lies between 0-10, which according to the scoring system is considered normal.
INTERPRETATION AND DISCUSSION
The Beck Depression Inventory (BDI) is a 21-item self-rated scale that measures key symptoms of depression including mood, pessimism, sense of failure, self-dissatisfaction, guilt, punishment, self-dislike, self-accusation, suicidal ideas, crying, irritability, social withdrawal, indecisiveness, and body image change. These aspects are presented as statements in the test. The subject was able to complete the test and obtained a score of 9 in the overall evaluation of the test which is interpreted as normal. From the subject’s responses, it is evaluated that there may be slight ups and downs but not severe enough to cause any significant impairment.
The aim of this test was to assess the level of depression. After the conduction of the test, the results concluded that the subject doesn’t have any major symptoms of depression and is doing well in day-to-day life.