Beck Depression Inventory - Limitations

Limitations

The BDI suffers from the same problems as other self-report inventories, in that scores can be easily exaggerated or minimized by the person completing them. Like all questionnaires, the way the instrument is administered can have an effect on the final score. If a patient is asked to fill out the form in front of other people in a clinical environment, for instance, social expectations have been shown to elicit a different response compared to administration via a postal survey.

In participants with concomitant physical illness the BDI's reliance on physical symptoms such as fatigue may artificially inflate scores due to symptoms of the illness, rather than of depression. In an effort to deal with this concern Beck and his colleagues developed the "Beck Depression Inventory for Primary Care" (BDI-PC), a short screening scale consisting of seven items from the BDI-II considered to be independent of physical function. Unlike the standard BDI, the BDI-PC produces only a binary outcome of "not depressed" or "depressed" for patients above a cutoff score of 4.

Although designed as a screening device rather than a diagnostic tool, the BDI is sometimes used by health care providers to reach a quick diagnosis.

The BDI is copyrighted, a fee must be paid for each copy used, and photocopying it is a violation of copyright. There is no evidence that the BDI-II is more valid or reliable than other depression scales, and public domain scales such as the Patient Health Questionnaire – Nine Item (PHQ-9) has been studied as a useful tool.

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