Sensitivity and specificity of the Beck Depression Inventory-II in persons with traumatic brain injury.
OBJECTIVE
Our objective was to examine the Beck Depression Inventory-II (BDI-II) in a traumatic brain injury (TBI) sample using a receiver operating characteristic (ROC) curve to determine how well the BDI-II identifies depression. An ROC curve allows for analysis of the sensitivity and specificity of a diagnostic test using various cutoff points to determine the number of true positives, true negatives, false positives, and false negatives.


METHODS
This was a secondary analysis of data gathered from an observational study. We examined BDI-II scores in a sample of 52 veterans with remote histories of TBI.


METHODS
This study was completed at a Veterans Affairs (VA) Medical Center.


METHODS
Participants were veterans eligible to receive VA health care services.


METHODS
Not applicable.


METHODS
Outcome measures included the BDI-II and the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-IV).


RESULTS
We generated an ROC curve to determine how well the BDI-II identifies depression using the SCID-IV as the criterion standard for diagnosing depression, defined here as a diagnosis of major depressive disorder. Results indicated a cutoff score of at least 19 if one has a mild TBI or at least 35 if one has a moderate or severe TBI. These scores maximize sensitivity (87%) and specificity (79%).


CONCLUSIONS
Clinicians working with persons with TBI can use the BDI-II to determine whether depressive symptoms warrant further assessment.
Homaifar
Beeta Y
BY
Veterans Affairs VISN 19 Mental Illness Research, Education and Clinical Center, Denver, CO, USA.
Brenner
Lisa A
LA
Gutierrez
Peter M
PM
Harwood
Jeri F
JF
Thompson
Caitlin
C
Filley
Christopher M
CM
Kelly
James P
JP
Adler
Lawrence E
LE
D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000150:complications*; D016001:Confidence Intervals; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000209:etiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011569:Psychiatric Status Rating Scales; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013313:Stress Disorders, Post-Traumatic / Q000150:complications; D014728:Veterans