Abstract
Background
The Beck Depression Inventory (BDI) is commonly used in bariatric surgery psychological assessments. However, several items may be measuring physical consequences of obesity (e.g., sleep disturbance, chronic pain, or sexual dysfunction) rather than depressive symptoms.
Methods
Bariatric surgery candidates (n = 210) completed a series of assessments including the BDI, a chronic pain assessment, and a semistructured clinical interview. Total BDI scores, subscale scores, and endorsement patterns of somatic versus cognitive-affective items were examined based on (1) the presence or absence of a depressive diagnosis or (2) the presence or absence of chronic pain, and optimal cut points were determined.
Results
Both the total BDI and cognitive–affective subscale had good discriminating accuracy between participants with and without depression, with an optimal cut point of 12 for the BDI and 7 for the cognitive–affective subscale. Bariatric surgery candidates with chronic pain had significantly higher mean total scores on the BDI (M = 12.5 ± 7.5) than those without chronic pain (M = 9.02 ± 6.7; p < 0.01), and those with chronic pain were significantly more likely to endorse many of the physical items than those without chronic pain.
Conclusions
The BDI, with or without the somatic items, appears to be a reasonable screening measure for depressive symptoms among bariatric surgery candidates and the subpopulation of those with chronic pain, although future investigations may wish to examine whether other measures would have improved discrimination accuracy.
Similar content being viewed by others
References
American Society for Metabolic and Bariatric Surgery. Fact sheet: bariatric surgery. http://www.asbs.org/Newsite07/media/fact-sheet1_bariatric-surgery.pdf. Accessed July 8, 2008.
Wadden T, Sarwer D, Williams N. Behavioral assessment and characteristics of patients seeking bariatric surgery. Obesity 2006;14:S51–2.
Bauchowitz AU, Gonder-Frederick LA, Olbrisch M, et al. Psychosocial evaluation of bariatric surgery candidates: a survey of present practices. Psychosom Med 2005;67:825–32.
Walfish S, Vance D, Fabricatore AN. Psychological evaluation of bariatric surgery applicants: procedures and reasons for delay or denial of surgery. Obes Surg 2007;17:1578–83.
Wadden TA, Butryn ML, Sarwer DB, et al. Comparison of psychosocial status in treatment-seeking women with class III vs. class I–II obesity. Obesity 2006;14:S90–8.
Cavanaugh SV, Clark DC, Gibbons RD. Diagnosing depression in the hospitalized medically ill. Psychosomatics 1983;24:809–15.
Plumb MM, Holland J. Comparative studies of psychological function in patients with advanced cancer—I. Self-reported depressive symptoms. Psychosom Med 1977;39:264–76.
Volk RJ, Pace TM, Parchman ML. Screening for depression in primary care patients: dimensionality of the short form of the Beck Depression Inventory. Psychol Assess 1993;5:173–81.
O’Keeffe T, Patterson EJ. Evidence supporting routine polysomnography before bariatric surgery. Obes Surg 2004;14:23–6.
Munoz DJ, Chen E, Fischer S, et al. Considerations for the use of the Beck Depression Inventory in the assessment of weight-loss surgery seeking patients. Obes Surg 2007;17:1097–101.
Williams AC, Richardson PH. What does the BDI measure in chronic pain? Pain 1993;55(2):259–66.
Brown WJ, Mishra G, Kenardy J, et al. Relationship between body mass index and well-being in young Australian women. Int J Obes 2000;24:1360–8.
Anandacoomarasamy A, Caterson I, Sambrook P, et al. The impact of obesity on the musculoskeletal system. Int J Obes 2008;32:211–22.
Thieme K, Turk DC, Flor H. Comorbid depression and anxiety in fibromyalgia syndrome: relationship to somatic and psychosocial variables. Psychosom Med 2004;66:837–44.
Beck AT, Ward CH, Mendelson M, et al. An inventory of measuring depression. Arch Gen Psychiatry 1961;4:53–63.
Kerns RD, Turk DC, Rudy TE. The West Haven-Yale Multidimensional Pain Inventory (WHYMPI). Pain 1985;23:345–56.
Beck AT, Steer RA, Garbin MG. Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Clin Psychol Rev 1988;8:77–100.
Youden WJ. An index for rating diagnostic tests. Cancer 1950;3:32–5.
Love A. Depression in chronic low back pain patients: adequacy of self-reports. J Clin Psychol 1987;43:84–9.
Turner JA, Romano JM. Self-report screening measures for depression in chronic pain patients. J Clin Psychol 1984;40:909–13.
Geisser ME, Roth RS, Robinson ME. Assessing depression among persons with chronic pain using the Center for Epidemiological Studies-Depression scale and the Beck Depression Inventory: a comparative analysis. Clin J Pain 1997;13:163–70.
Beck AT, Steer RA, Brown GK. Manual for the Beck Depression Inventory—II. San Antonio: Psychological Corporation; 1996.
Beck AT, Guth D, Steer RA, et al. Screening for major depression disorders in medical inpatients with the Beck Depression Inventory for Primary Care. Behav Res Ther 1997;35:785–91.
Steer RA, Cavalieri TA, Leonard DM, et al. Use of the Beck Depression Inventory for Primary Care to screen for major depressive disorders. Gen Hosp Psychiatry 1999;21:106–11.
Williams JW, Noel PH, Cordes JA, et al. Is this patient clinically depressed? JAMA 2002;287:1160–70.
Fabricatore AN, Sarwer DB, Wadden TA, et al. Impression management or real change? Reports of depressive symptoms before and after the preoperative psychological evaluation for bariatric surgery. Obes Surg 2007;17:1213–9.
Walfish S. Reducing Minnesota Multiphasic Personality Inventory defensiveness: effect of specialized instructions on retest validity in a sample of preoperative bariatric patients. Surg Obes Relat Dis 2007;3:184–8.
Acknowledgements
A portion of this research was presented at the 2007 Obesity Society conference in New Orleans, LA.
This research was conducted when the first author was at the Duke Center for Metabolic and Weight Loss Surgery.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Krukowski, R.A., Friedman, K.E. & Applegate, K.L. The Utility of the Beck Depression Inventory in a Bariatric Surgery Population. OBES SURG 20, 426–431 (2010). https://doi.org/10.1007/s11695-008-9717-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11695-008-9717-2