Win Khine Lae, Kawakami Norito, Htet Doe Gyaw
1Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan.
Department of Psychiatry and Mental Health, Defense Services Medical Academy, Mingaladon Township, Yangon, 11021 Myanmar.
Ann Gen Psychiatry. 2019 Jul 22;18:12. doi: 10.1186/s12991-019-0236-4. eCollection 2019.
The Beck Depression Inventory II (BDI-II) has been accepted as one of the most commonly used self-report measures for depression. However, there is no study examining the psychometric properties of the BDI-II among substance users in low- and middle-income countries such as Myanmar. Therefore, this study aimed to evaluate the suitability of using this instrument in substance users and to examine the reliability and diagnostic efficiency to be compared with the International Classification of Diseases (ICD-10) among substance users in Northern Shan State of Myanmar.
A respondent-driven sampling (RDS) method was applied for recruiting the participants in this study, and total 230 substance users were recruited. On the other hand, 50 participants who visited the drop-in center (DIC) were screened for depressive symptoms using ICD-10 during the days when one consultant psychiatrist doctor was presented. These participants were interviewed face-to-face by the consultant psychiatrist using a semi-structured questionnaire including the Myanmar version of the BDI-II (mBDI-II).
The mBDI-II showed moderate accuracy with an area under the curve of 0.68. The optimal cutoff score was 10 with the highest Youden index (0.48), and it had high sensitivity and specificity (0.78 and 0.70). The Cronbach's alpha coefficients for clinically depressed and non-clinically depressed substance users were 0.91 and 0.93, respectively. Confirmatory factor analysis of the mBDI-II indicated that a three-factor solution (cognitive, affective, and somatic) was the best fit for substance users.
The mBDI-II has sound psychometric properties among substance users with moderate accuracy and range of possible cutoff scores together with sensitivity and specificity.
贝克抑郁量表第二版（BDI-II）已被公认为最常用的抑郁症自我报告测量工具之一。然而，在缅甸等低收入和中等收入国家，尚无研究考察BDI-II在药物使用者中的心理测量特性。因此，本研究旨在评估该工具在药物使用者中的适用性，并检验其可靠性和诊断效率，以便与缅甸掸邦北部药物使用者中的《国际疾病分类》（ICD-10）进行比较。
本研究采用应答者驱动抽样（RDS）方法招募参与者，共招募了230名药物使用者。另一方面，在有一名顾问精神科医生坐诊的日子里，对50名到访救助中心（DIC）的参与者使用ICD-10筛查抑郁症状。这些参与者由顾问精神科医生使用包括缅甸版BDI-II（mBDI-II）的半结构化问卷进行面对面访谈。
mBDI-II显示出中等准确性，曲线下面积为0.68。最佳截断分数为10，约登指数最高（0.48），且具有较高的敏感性和特异性（分别为0.78和0.70）。临床抑郁和非临床抑郁药物使用者的克朗巴哈系数分别为0.91和0.93。mBDI-II的验证性因素分析表明，三因素解决方案（认知、情感和躯体）最适合药物使用者。
mBDI-II在药物使用者中具有良好的心理测量特性，准确性中等，可能的截断分数范围以及敏感性和特异性均较好。
