The validity of the Beck Depression Inventory as a screening and diagnostic instrument for depression in patients with Parkinson's disease

Authors

  • Albert F. G. Leentjens MD,

    Corresponding author
    1. Department of Psychiatry, Maastricht University Hospital, Maastricht, The Netherlands
    2. Institute for Brain and Behaviour, Maastricht University, Maastricht, The Netherlands
    • Department of Psychiatry, Maastricht University Hospital, PO Box 5800, 6202 AZ Maastricht, The Netherlands
    Search for more papers by this author
  • Frans R. J. Verhey MD, PhD,

    1. Department of Psychiatry, Maastricht University Hospital, Maastricht, The Netherlands
    2. Institute for Brain and Behaviour, Maastricht University, Maastricht, The Netherlands
    Search for more papers by this author
  • Gert-Jan Luijckx MD, PhD,

    1. Department of Neurology, Maasland Hospital Sittard, Maastricht, The Netherlands
    Search for more papers by this author
  • Jaap Troost MD, PhD

    1. Institute for Brain and Behaviour, Maastricht University, Maastricht, The Netherlands
    2. Department of Neurology, Maastricht University Hospital, Maastricht, The Netherlands
    Search for more papers by this author

Abstract

PURPOSE

To evaluate the validity of the Beck Depression Inventory (BDI) as a screening and diagnostic scale for depression in Parkinson's disease (PD).

PATIENTS AND METHODS

Fifty-three nondemented patients with PD were diagnosed according to a standardized protocol consisting of the depression module of the Structured Clinical Interview for DSM axis I disorders (SCID) and the BDI. A “receiver operating characteristics” (ROC) curve was obtained and the sensitivity, specificity, positive and negative predictive values (PPV and NPV, respectively) were calculated for different cut-off points of the BDI.

RESULTS

Maximum discrimination was obtained with a cut-off score of 13/14. High sensitivity and NPV were obtained with cut-off scores of 8/9 or lower; a high specificity and PPV were obtained with cut-off scores of 16/17 or higher. The area under the ROC curve was 85.67%.

CONCLUSION

A single cut-off score on the BDI to distinguish nondepressed from depressed patients with PD is not feasible. If one accepts the low specificity, then the BDI can be used as a valid screening instrument for depression in PD with a cut-off of 8/9. With a cut-off score of 16/17, it can be used as a diagnostic scale, at the cost of a low sensitivity. The use of diagnostic criteria for depression remains necessary.

Ancillary