Beck Depression Inventory

BDI-I

The original BDI measure consisted of 21 multiple-choice questions asking the patient to rate their feelings over the past week. Questions were ranked on a Likert-type severity scale from levels 0 to 3 (3 representing more intense or severe feelings). Respondents would be instructed to circle the number corresponding to the statement that was most accurate, and the responses were summed to yield a total score. Higher total scores indicated a more severe number of depressive symptoms.

Beck developed standard ranges and cutoffs for the scores, so that a clinical impression could be easily assessed from the total sum. Descriptors and ranges were minimal (0–9), mild (10–18), moderate (19–29), and severe (30–63).

BDI-IA

The BDI-IA was published in 1978 as an amended (revised) version of Beck’s original [Page 185]questionnaire. Improvements included rewording and restructuring some items to remove the (a) and (b) choices to make the choices clearer for patients. In the original questionnaire, examinees were asked to answer questions based on their mood over the preceding week. This time frame was lengthened to 2 weeks on the BDI-IA so as to allow for a wider range of possible life events and emotions that might be tabulated.

Despite increased ease of administration and use in this version, the BDI-IA only addressed six of the nine Diagnostic and Statistical Manual of Mental Disorders, Third edition (DSM-III) symptom criteria for major depressive disorder. This flaw prompted the second revision of the BDI.

BDI-II

The second revision of the BDI occurred with the advent of the DSM-IV in 1996. This version, the most recent as of 2017, is one of the most widely used depression screening measures. The BDI-II retains a 21-question format, although 18 items were reworded to reflect new diagnostic criteria accompanying implementation of the DSM-IV. Questions pertaining to suicide, interest in sex, and feelings of punishment were not revised. Items referring to sleep and appetite were reworded to account for both increases and decreases in these domains as DSM-IV allowed for either direction of the disturbance to count as symptom criteria. Items assessing body image, hypochondriasis, and difficulty working were removed, as they no longer reflected diagnostic criteria.

Identical to the BDI-IA, the BDI-II asks individuals to choose their responses based on their thoughts or feelings over the most recent 2-week span. Respondents circle the number of the statement that most closely matched their feelings or thoughts, with 0 being the least severe feeling and 3 being the most severe feeling. All 21 items are tabulated, with higher total sums indicating a more severe number of depressive symptoms. BDI-II descriptors are minimal (0–13), mild (14–19), moderate (20–28), and severe (29–63).

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