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Validity of the Beck Depression Inventory as a Screening Tool for a Clinical Mood Disorder in Bariatric Surgery Candidates

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Abstract

Background

The Beck Depression Inventory (BDI) is one of the most commonly used instruments to assess depression in persons with obesity. While it has been validated in normal and psychiatric populations, in obese populations, its validity remains uncertain. This study aimed to investigate the validity and reliability of the BDI-IA and BDI-II in severely obese bariatric surgery candidates.

Methods

Consecutive new candidates at a bariatric surgery clinic were invited to participate in the study by their consulting surgeon. All candidates were assessed using the Structured Clinical Interview for DSM-IV Disorders (SCID-I); 118 completed the BDI-IA and 83 completed the BDI-II. Two hundred one patients (response rate, 88 %) participated in the study. The current sample (82 % female) had an average body mass index of 42.83 ± 6.34 and an average age of 45 ± 12 years.

Results

Based on the SCID-I, 54 candidates (26.9 %) met the criteria for a mood disorder, with 37 meeting the criteria for current major depressive disorder. Individuals diagnosed with a clinical mood disorder had significantly higher scores on the BDI (BDI-IA, 23.59 ± 9.69 vs. 12.76 ± 8.29; BDI-II, 22.93 ± 5.22 vs. 11.25 ± 8.44). Our results indicated that, as a screening tool for a clinical mood disorder, the BDI-II had an optimal cutoff of 13, with a sensitivity of 100 and specificity of 67.75.

Conclusions

Results indicated that the BDI-IA should not be used as a tool to measure depressive symptomatology in obese bariatric surgery candidates. No cutoff was identified with adequate sensitivity and specificity, and over 20 % of patients were misclassified. As a screening tool for a clinical mood disorder, the BDI-II was adequate; however, prevalence rates were significantly overestimated.

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Conflict of Interest

The Centre for Obesity Research and Education (CORE) received funding from Allergan for research support. The grant is not tied to any specified research projects and Allergan have no control of the protocol, analysis, and reporting of any studies. CORE also receives a grant from Applied Medical towards the educational programs. Dr. Wendy Brown reported receiving an honorarium from Allergan for attending a scientific advisory panel in London in 2009. Dr. Paul O’Brien reported having written a patient information book entitled “The LAP-BAND Solution: A Partnership for Weight Loss” which was published by Melbourne University Publishing in 2007. Most copies are given to patients without charge, but he reports that he derives a financial benefit from the copies that are sold. He also reports receiving compensation as the national medical director of the American Institute of Gastric Banding, a multicenter facility, based in Dallas, TX, USA that treats obesity predominantly by gastric banding. No other authors reported disclosures.

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Authors and Affiliations

  1. Centre for Obesity Research and Education (CORE), The Alfred Centre, The Alfred Hospital, Monash University, Level 6, 99 Commercial Road, Melbourne, Victoria, 3004, Australia

    Melissa J. Hayden, Wendy A. Brown, Leah Brennan & Paul E. O’Brien

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  1. Melissa J. Hayden
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  2. Wendy A. Brown
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  3. Leah Brennan
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  4. Paul E. O’Brien
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Correspondence to Melissa J. Hayden.

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Hayden, M.J., Brown, W.A., Brennan, L. et al. Validity of the Beck Depression Inventory as a Screening Tool for a Clinical Mood Disorder in Bariatric Surgery Candidates. OBES SURG 22, 1666–1675 (2012). https://doi.org/10.1007/s11695-012-0682-4

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