Department of Child Health, Christian Medical College, Vellore, India.
Child Adolesc Psychiatry Ment Health. 2007 Aug 9;1(1):8. doi: 10.1186/1753-2000-1-8.
There is increasing interest in identifying adolescents with depression in primary care settings by paediatricians in India. This article studied the diagnostic accuracy, reliability and validity of Beck Depression Inventory (BDI) while used by paediatricians in a primary care setting in India.
181 adolescents attending 3 schools were administered a back translated Tamil version of BDI by a paediatrician to evaluate its psychometric properties along with Children's Depression Rating Scale (CDRS-R) for convergent validity. Clinical diagnosis of depressive disorders, for reference standard, was based on ICD-10 interview by an independent psychiatrist who also administered the Impact of Event Scale (IES) for divergent validity. Appropriate analyses for validity and diagnostic accuracy both at the item and scale levels were conducted.
A cut-off score of >or= 5 (Sn = 90.9%, Sp = 17.6 %) for screening and cut-off score of >or= 22 (Sn = 27.3%, Sp = 90%) for diagnostic utility is suggested. The 4 week test - retest reliability was good (r = 0.82). In addition to the adequate face and content validity, BDI has very good internal consistency (alpha = 0.96), high convergent validity with CDRS-R (r = 0.72; P = 0.001), and high discriminant validity with IES (r = 0.26; P = 0.23). There was a moderate concordance rate with the reference standard (54.5%) in identifying depression among the adolescents. Factor analysis replicated the 2-factor structure explaining 30.5 % of variance.
The BDI proved to be a psychometrically sound measure for use by paediatricians in a primary care setting in India. The possibility of screening for depressive disorders through the use of BDI may be helpful in identifying probable cases of the disorder among adolescents.
在印度，儿科医生越来越有兴趣通过初级保健来识别患有抑郁症的青少年。本文研究了贝克抑郁量表（BDI）在印度初级保健环境中由儿科医生使用时的诊断准确性、可靠性和有效性。
181 名在 3 所学校就诊的青少年由一名儿科医生用回译的泰米尔语版 BDI 进行评估，以评估其与儿童抑郁评定量表（CDRS-R）的同时效度。抑郁障碍的临床诊断，作为参考标准，是基于独立精神科医生进行的 ICD-10 访谈，同时也进行了事件影响量表（IES）的差异效度。在项目和量表水平上都进行了适当的有效性和诊断准确性分析。
建议筛查的截断分数>或=5（Sn=90.9%，Sp=17.6%），诊断效用的截断分数>或=22（Sn=27.3%，Sp=90%）。4 周的测试-重测信度良好（r=0.82）。除了足够的表面和内容效度外，BDI 具有非常好的内部一致性（α=0.96），与 CDRS-R 具有很高的收敛效度（r=0.72；P=0.001），与 IES 具有很高的判别效度（r=0.26；P=0.23）。在识别青少年中的抑郁症方面，与参考标准的一致性率适中（54.5%）。因子分析复制了解释 30.5%方差的 2 因素结构。
BDI 被证明是印度初级保健环境中儿科医生使用的一种具有心理测量学意义的措施。通过使用 BDI 进行抑郁障碍的筛查，可能有助于识别青少年中可能存在的该障碍病例。
