Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via HighWire Citing Articles via Google Scholar Articles by Scalera, A. Articles by Shear, N. Search for Related Content PubMed Citation Articles by Scalera, A. Articles by Shear, N. AIDS/HIV

Use and Citation of Beck Depression Inventory to Assess Depression in HIV Infection

Key Words: AIDS/HIV • Personality Disorders

TO THE EDITOR: Depressive disorders are common in the course of HIV infection. The estimated lifetime prevalence of depressive disorders in those infected with HIV ranges from 21% to 61%.¹ The Beck Depression Inventory (BDI) is one of the most commonly used instruments for assessing depressive disorders in HIV-infected populations. HIV researchers may be unaware that a new version, the Beck Depression Inventory—Second Edition (BDI-II) has been available since 1996. For the most part, the original 1961 (BDI) or amended 1979 versions (BDI-IA) continue to be used and cited in research studies of HIV-infected populations. For example, Rabkin and colleagues² used the BDI to evaluate psychological consequences of combination antiretroviral treatment in men with symptomatic HIV infection or AIDS. The study was conducted between 1995 and 1997. During the study period the BDI-IA was available, but the BDI cited in the paper was the original 1961 version. Why was the original cited or used? Could it be that the BDI-IA was used but incorrectly cited? Although the aggregated score for the BDI was provided, it is impossible to distinguish which version was used. Since 1996, there have been eight studies using the BDI to assess depression in HIV-infected populations that have all cited the original 1961 version. In two related studies in separate publications,^3,4 the authors used the BDI but did not provide a reference. In order to distinguish which version of the BDI was used in the studies, the reader must be aware that the BDI-II constitutes a substantial revision of previous versions of the BDI. In the BDI-II, only 3 items (punishment, suicidal ideas, and loss of libido) of 21 were not reworded; 4 items (weight loss, body image change, somatic preoccupation, and work difficulty) were eliminated and replaced by 4 new items (agitation, worthlessness, concentration difficulty, and loss of energy); and 2 items (sleep and appetite) were changed to allow for increases as well as decreases.⁵ Because the authors provided average scores for each BDI item, the version used could be distinguished but only with prior knowledge of the differences among versions. Results from studies in which the version of the BDI used is not specified can be misinterpreted or confusing, particularly because BDI-IA and BDI-II scores are not correlated, and a calibration scale was developed for researchers seeking to compare results. Citation inaccuracies could also mislead investigators about which BDI version to use. Several refinements in the definition of depression have accrued over the past 40 years.⁵ The BDI-II was developed to correspond to criteria for diagnosing depressive disorders listed in DSM-IV,⁶ whereas previous versions were based on descriptive symptoms reported by psychiatric patients with depression and not any particular theory of depression.⁵ Although we restrict our commentary to studies in HIV-infected populations, the BDI is used to assess depression in those with other chronic diseases, and the errors and inaccuracies concerning the BDI are most likely pervasive.

REFERENCES

1. Elliott AJ, Roy-Byrne PP: Major depressive disorder and HIV-1 infection: a review of treatment trials. Semin Clin Neuropsychiatry 1998; 3:137-150[Medline]
2. Rabkin JG, Ferrando SJ, Lin S-H, et al: Psychological effects of HAART: a 2-year study. Psychosom Med 2000; 62:413-422[Abstract/Free Full Text]
3. Cockram A, Judd FK, Mjich A, Norman T: The evaluation of depression in inpatients with HIV disease. Aust N Z J Psychiatry 1999; 33:344-352[CrossRef][Medline]
4. Judd FK, Mjich AM: Depressive symptoms in patients with HIV infection. Aust N Z J Psychiatry 1996; 30:104-109[Medline]
5. Beck AT, Steer RA, Brown GK: Manual for Beck Depression Inventory II (BDI-II). San Antonio, TX, Psychology Corporation, 1996
6. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. Washington, DC, American Psychiatric Association, 1994

This article has been cited by other articles:

				R. G. Hoffman, M. A. Cohen, C. A. Alfonso, J. J. Weiss, S. Jones, M. Keller, J. R. Condemarin, N.-M. Chiu, and J. M. Jacobson Treatment of Interferon-Induced Psychosis in Patients With Comorbid Hepatitis C and HIV Psychosomatics, October 1, 2003; 44(5): 417 - 420. [Full Text] [PDF]

Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via HighWire Citing Articles via Google Scholar Articles by Scalera, A. Articles by Shear, N. Search for Related Content PubMed Citation Articles by Scalera, A. Articles by Shear, N. AIDS/HIV

Get information about faster international access.

Privacy Policy

Copyright © 2002 Academy of Psychosomatic Medicine. All rights reserved.

Home | Search | Current Issue | Past Issues | Subscribe | All APPI Journals | Help | Contact Us