The Beck depression inventory-II in adolescent mental health patients: cut-off scores for detecting depression and rating severity.
The Beck Depression Inventory-Second Edition (BDI-II) was developed as an indicator of the presence and severity of depression in psychiatric patients from age 13. Its cut-off scores were derived from an adult sample and differentiate four categories of severity but contain no screening cut-off score for classifying patients as depressed vs. nondepressed. We aimed to determine this screening cut-off score and to examine the utility of the severity cut-off scores for adolescents in mental health care. 88 adolescent psychiatric patients (13-16 years, 58% female) completed the German BDI-II. A structured diagnostic interview served as the reference standard for computing receiver operating characteristic (ROC) curves and identified 24 adolescents (27%) as depressed. ROC analysis of depressed vs. nondepressed patients yielded an area under the curve (AUC) value of 0.93. The optimal screening cut-off score according to Youden's Index was ≥23, where sensitivity was 0.88 and specificity was 0.92. The severity cut-off scores yielded satisfying sensitivity (≥0.89) and specificity (≥0.72) for mild and moderate but not for severe depression. Our findings indicate that the BDI-II can be recommended for screening for depressive disorders in adolescent mental health patients. However, the currently used severity cut-off scores may be suboptimal for this population.
Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Ludwig-Maximilians-Universität München, Bavaria, Germany.
Kathrin
K
Dolle
Gerd
G
Schulte-Körne
Anna Maria
AM
O'Leary
Nikolaus
N
von Hofacker
Yonca
Y
Izat
Antje-Kathrin
AK
Allgaier
D000293:Adolescent; D003863:Depression / Q000175:diagnosis*; D003866:Depressive Disorder / Q000175:diagnosis*; D059026:Diagnostic Self Evaluation; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index