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Assessment of depression in medical patients: systematic review of the utility of the Beck Depression Inventory-II


To perform a system review of the utility of the Beck Depression Inventory (BDI) for detecting depression in medical settings. This article focuses on the revised version of the scale (BDI-II), which was reformulated according to DSM-IV criteria for major depression. We examine relevant investigations with the BDI-II for measuring depressions in medical settings to sketch a guideline for practicing clinicians. Seventy articles met the inclusion and exclusion criteria. Validation studies of the BDI-II, in both primary care and hospital setting, were found for clinics of cardiology, neurology, obstetrics, brain injury, nephrology, chronic pain, chronic fatigue, oncology, and infectious disease. The BDI- II showed high reliability and good correlation with measures of depression and anxiety. Its threshold to detect depression varied according to the type of patients, suggesting the need of adjusting the cutoff points. Somatic and cognitive-affective dimension described the latent structure of the instrument. The BDI-II can be easily adapted in most clinical conditions for detecting major depression and recommending an appropriate intervention. Although this scale represents a sound path for detecting depression in medical conditions, the clinician should seek evidence of score interpretability before using the BDI-II to make clinical decisions. (AU)

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