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Validity and Clinical Utility of Subtyping by the Beck Depression Inventory in Women Seeking Gastric Bypass Surgery

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Abstract

Background

The Beck Depression Inventory (BDI) is commonly used in the screening and evaluation process with bariatric surgery candidates despite relatively limited psychometric evidence in this patient group. We examined the validity of the BDI and its clinical utility for subtyping women seeking gastric bypass surgery.

Methods

One hundred twenty-four women evaluated for gastric bypass surgery were administered the Structured Clinical Interview for DSM-IV (SCID-I/P) and completed a self-report battery of psychosocial measures including the BDI.

Results

Based on the SCID-I/P, 12.9 % (n = 16) met criteria for current mood disorder. Receiver operating characteristic (ROC) curve analysis revealed the BDI had a good area under the curve (0.788) for predicting SCID-I/P mood disorder diagnosis; BDI score of >15 optimized both sensitivity and specificity. Patients diagnosed with SCID-I/P mood disorders had significantly higher levels of eating disorder psychopathology, self-esteem, and shame, than those without mood disorders. Based on a BDI cut-off score of >15, 41.9 % (n = 52) were categorized as high-BDI and 58.1 % (n = 72) as low-BDI. Patients characterized as high-BDI also had significantly higher levels of all associated measures than those with low-BDI; effect sizes for the differences by BDI subtyping were generally 2–3 times greater than those observed when comparing SCID-I/P-based mood versus no mood disorder subgroups.

Conclusions

In women seeking gastric bypass surgery, the BDI demonstrated limited acceptability efficiency for identifying mood disorders with a cut-point score of >15. When identifying clinical severity, however, subtyping women by BDI scores of >15 may identify a significantly more disturbed subgroup than relying on a SCID-I/P-generated mood disorder diagnosis.

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Acknowledgments

Dr. Grilo was supported, in part, by grants from the National Institutes of Health (K24 DK070052, R01 DK098492). Dr. Barnes was supported by grants from the National Institutes of Health (K23 DK092279). No additional funding was received for the completion of this work.

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Authors and Affiliations

  1. Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA

    Valentina Ivezaj, Rachel D. Barnes & Carlos M. Grilo

  2. Department of Psychology, Yale University, New Haven, CT, USA

    Carlos M. Grilo

  3. Yale University School of Medicine, Program for Obesity, Weight, and Eating Research, 301 Cedar Street, 2nd Floor, New Haven, CT, 06519-1638, USA

    Valentina Ivezaj

Authors
  1. Valentina Ivezaj
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  2. Rachel D. Barnes
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Correspondence to Valentina Ivezaj.

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Conflict of Interest

Dr. Ivezaj declares that there is no conflict of interest. Dr. Barnes reports grants from NIDDK. Dr. Grilo reports no relevant conflicts of interest with respect to this work but more generally reports that he has received grants from the National Institutes of Health, consulting fees from Shire and Sunovion, honoraria from the American Psychological Association and from universities and scientific conferences for grand rounds and lecture presentations, speaking fees for various CME activities, consulting fees from American Academy of CME, Vindico Medical Education CME, and General Medical Education CME, and book royalties from Guilford Press and from Taylor Francis Publishers.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Ivezaj, V., Barnes, R.D. & Grilo, C.M. Validity and Clinical Utility of Subtyping by the Beck Depression Inventory in Women Seeking Gastric Bypass Surgery. OBES SURG 26, 2068–2073 (2016). https://doi.org/10.1007/s11695-016-2047-x

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