Discriminability of the Beck Depression Inventory and its Abbreviations in an Adolescent Psychiatric Sample

Figures & Tables

Condition*	Version	Diagnosis +			Diagnosis −			Brunner–Munzel test		Stochastic Superiority

		n	M	SD	n	M	SD	Statistic	p	Estimate	CI
MDD vs. no depr.	BDI-1A	351	30.22	9.64	239	12.13	9.49	31.7	< 0.001	0.902	[0.88, 0.93]
MDD vs. no depr.	BDI-SF	359	20.24	6.60	243	7.75	6.56	32.3	< 0.001	0.902	[0.88, 0.93]
MDD vs. no depr.	BDI-PC	361	11.58	3.91	245	4.54	3.91	29.5	< 0.001	0.892	[0.87, 0.92]
MDD vs. no depr.	BDI-6	368	10.02	3.04	246	4.00	3.29	32.7	< 0.001	0.899	[0.88, 0.92]
Depr. vs. none	BDI-1A	389	29.13	10.04	239	12.13	9.49	28.3	< 0.001	0.884	[0.86, 0.91]
Depr. vs. none	BDI-SF	397	19.53	6.87	243	7.75	6.56	28.7	< 0.001	0.885	[0.86, 0.91]
Depr. vs. none	BDI-PC	399	11.20	4.03	245	4.54	3.91	26.8	< 0.001	0.876	[0.85, 0.90]
Depr. vs. none	BDI-6	406	9.74	3.12	246	4.00	3.29	29.8	< 0.001	0.886	[0.86, 0.91]
MDD vs. no MDD	BDI-1A	351	30.22	9.64	275	13.04	9.55	30.7	< 0.001	0.892	[0.87, 0.92]
MDD vs. no MDD	BDI-SF	359	20.24	6.60	279	8.42	6.63	30.9	< 0.001	0.891	[0.87, 0.92]
MDD vs. no MDD	BDI-PC	361	11.58	3.91	281	4.95	3.96	28.1	< 0.001	0.880	[0.85, 0.91]
MDD vs. no MDD	BDI-6	368	10.02	3.04	282	4.40	3.35	30.2	< 0.001	0.883	[0.86, 0.91]

Version	Items	Factor score cut-off	AP	Confusion matrix					Basic ratios			κ	Diagnostic odds ratio		Number needed to diagnose		Global test		Individual test adjusted p-values

				TP	FP	FN	TN	Sens.	Spec.	PPV	NPV		DOR	95% Cl	NND	95% Cl	Stat.	Adj. p	Sens.	Spec.
BDI-1A	21	−0.35	70%	350	85	23	164	0.938	0.659	0.805	0.877	0.623	29.36	[17.87, 48.24]	1.68	[1.48, 1.98]	2.70	0.250	–	–
BDI-SF	13	−0.33	70%	350	85	23	164	0.938	0.659	0.805	0.877	0.623	29.36	[17.87, 48.24]	1.68	[1.48, 1.98]	1.34	0.512	–	–
BDI-PC	7	−0.32	71%	350	90	23	159	0.938	0.639	0.795	0.874	0.604	26.88	[16.39, 44.09]	1.73	[1.52, 2.06]	0.04	0.980	–	–
BDI-6	6	−0.35	70%	350	86	23	163	0.938	0.655	0.803	0.876	0.619	28.84	[17.56, 47.37]	1.69	[1.48, 2.00]	0.36	0.835	–	–

Item	Content	Item included in version			Factor loading	Item thresholds

		BDI-SF	BDI-PC	BDI-6		1	2	3
1	Mood	✓	✓	✓	0.80	−0.51	0.64	1.52
2	Pessimism	✓	✓	–	0.75	−0.83	0.25	1.12
3	Sense of failure	✓	✓	–	0.84	−0.74	0.45	1.11
4	Lack of satisfaction	✓	✓	–	0.83	−0.55	0.44	1.46
5	Guilty feeling	✓	–	✓	0.88	−0.46	0.28	1.00
6	Sense of punishment	–	–	–	0.65	0.07	0.74	1.27
7	Negative self-view	✓	✓	–	0.84	−0.69	0.32	0.96
8	Self-accusations	–	✓	–	0.81	−0.90	−0.21	0.31
9	Self-destructiveness	✓	✓	–	0.70	−0.68	1.12	2.11
10	Crying	–	–	–	0.71	−0.48	0.26	0.69
11	Irritability	–	–	✓	0.66	−0.92	0.32	1.31
12	Social withdrawal	✓	–	–	0.74	−0.36	0.64	1.82
13	Indecisiveness	✓	–	✓	0.75	−0.68	0.05	1.60
14	Negative body image	✓	–	–	0.73	−0.13	0.36	0.63
15	Work inhibition	✓	–	✓	0.71	−0.91	−0.03	1.49
16	Sleep disturbance	–	–	–	0.56	−0.67	0.81	1.34
17	Fatigability	✓	–	✓	0.78	−0.78	0.08	1.26
18	Loss of appetite	✓	–	–	0.58	−0.05	0.73	1.54
19	Weight loss	–	–	–	0.24	0.68	1.19	1.73
20	Somatic preoccupation	–	–	–	0.42	0.25	1.48	1.93
21	Loss of libido	–	–	–	0.58	0.20	0.93	1.62

Variable	Males	Females	Total
Participants	202	550	752
Age, mean	16.74	16.47	16.55
Age, SD	1.67	1.62	1.64
Major depressive disorder	84 (42%)	294 (53%)	378 (50%)
Dysthymia	24 (12%)	87 (16%)	111(15%)
Other depressive disorder	7 (3.5%)	29 (5%)	36 (5%)
Exclusion diagnosis	6 (3%)	61 (11%)	67 (9%)

Version	Items	Mean cut-off	AP	Confusion matrix					Basic ratios			κ	Diagnostic odds ratio		Number needed to diagnose		Global test		Individual test adjusted p-values

				TP	FP	FN	TN	Sens.	Spec.	PPV	NPV		DOR	95% Cl	NND	95% Cl	Stat.	Adj. p	Sens.	Spec.
BDI-1A	21	0.76	71%	350	89	23	160	0.938	0.643	0.797	0.874	0.608	27.36	[16.67, 44.89]	1.72	[1.51, 2.05]	–	–	–	–
BDI-SF	13	0.82	69%	348	84	25	165	0.933	0.663	0.806	0.868	0.620	27.34	[16.86, 44.34]	1.68	[1.48, 1.99]	2.22	0.329	–	–
BDI-PC	7	0.86	72%	354	95	19	154	0.949	0.618	0.788	0.890	0.598	30.20	[17.82, 51.19]	1.76	[1.54, 2.10]	3.12	0.211	–	–
BDI-6	6	1.00	69%	349	81	24	168	0.936	0.675	0.812	0.875	0.634	30.16	[18.45, 49.29]	1.64	[1.45, 1.93]	2.36	0.307	–	–

BDI version	Optimization criterion	Subgroup	Optimal cut-off	κ	Sensitivity	Specificity	AUC	DOR	NND
BDI-1A	Cohen's kappa	-	0.89	0.638	0.895	0.731	0.902	–	1.60
BDI-SF	Cohen's kappa	-	1.01	0.619	0.845	0.775	0.903	–	1.61
BDI-PC	Cohen's kappa	-	1.10	0.634	0.861	0.771	0.893	–	1.58
BDI-6	Cohen's kappa	-	1.04	0.615	0.866	0.743	0.900	–	1.64
BDI-1A	Cohen's kappa	Male	0.86	0.682	0.821	0.860	0.910	–	1.47
BDI-1A	Cohen's kappa	Female	0.90	0.611	0.927	0.654	0.896	–	1.72
BDI-SF	Cohen's kappa	Male	0.79	0.629	0.869	0.763	0.912	–	1.58
BDI-SF	Cohen's kappa	Female	1.07	0.597	0.886	0.699	0.896	–	1.71
BDI-PC	Cohen's kappa	Male	1.01	0.646	0.738	0.903	0.893	–	1.56
BDI-PC	Cohen's kappa	Female	1.12	0.605	0.896	0.692	0.890	–	1.70
BDI-6	Cohen's kappa	Male	0.95	0.650	0.857	0.796	0.895	–	1.53
BDI-6	Cohen's kappa	Female	1.14	0.623	0.910	0.692	0.899	–	1.66
BDI-1A	Misclassification cost 1:1	-	0.86	0.638	0.895	0.731	0.902	–	1.60
BDI-SF	Misclassification cost 1:1	-	0.89	0.606	0.893	0.699	0.903	–	1.69
BDI-PC	Misclassification cost 1:1	-	1.05	0.634	0.861	0.771	0.893	–	1.58
BDI-6	Misclassification cost 1:1	-	1.02	0.615	0.866	0.743	0.900	–	1.64
BDI-1A	Misclassification cost 1:3	-	0.62	0.599	0.962	0.602	0.902	–	1.77
BDI-SF	Misclassification cost 1:3	-	0.68	0.611	0.979	0.594	0.903	–	1.75
BDI-PC	Misclassification cost 1:3	-	0.72	0.594	0.949	0.614	0.893	–	1.77
BDI-6	Misclassification cost 1:3	-	0.74	0.565	0.957	0.574	0.900	–	1.88