Factor structure and diagnostic efficiency of the BDI-II in treatment-seeking substance users.
Screening instruments are needed to rapidly and efficiently identify depression in drug and alcohol users. The Beck Depression Inventory-Second Edition (BDI-II) has excellent validity in psychiatric, normative and primary care samples, but its diagnostic efficiency has not been examined in substance users. Using a large sample of treatment-seeking substance users and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) to establish diagnosis, we examined the factor structure of the BDI-II and its ability to detect clinical depression, defined as the presence of a Major Depressive Disorder (MDD) or substance-induced depression. A three-factor structure provided the best fit, and the diagnostic efficiency of the BDI-II was moderate, and independent of gender and substance of abuse. Subscores had lower diagnostic efficiency than the BDI-II total score. A range of possible cutoff scores with corresponding sensitivity, specificity, positive predictive power and negative predictive power is provided to aid clinicians and researchers in choosing the optimal parameters for their screening needs.
Seignourel
Paul J
PJ
Department of Psychiatry and Behavioral Sciences, University of Texas, 1300 Moursund Street, Houston, TX 77030, USA. SeignouP@einstein.edu
Green
Charles
C
Schmitz
Joy M
JM
D000293:Adolescent; D000328:Adult; D000368:Aged; D003863:Depression / Q000175:diagnosis* / Q000523:psychology*; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D012372:ROC Curve; D015203:Reproducibility of Results; D012727:Sex Characteristics; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000523:psychology*