Reliability and validity of the Beck Depression Inventory in patients with Parkinson's disease

Leiden University, Leyden, South Holland, Netherlands
Movement Disorders (Impact Factor: 5.68). 05/2006; 21(5):668-72. DOI: 10.1002/mds.20792
Source: PubMed


We evaluated the validity, reliability, and potential responsiveness of the Beck Depression Inventory (BDI) in patients with Parkinson's disease (PD). In part 1 of the study, 92 patients with PD underwent a structured clinical interview for DSM major depression and based on this patients were considered depressed (PD-D) or nondepressed (PD-ND). Subsequently, patients filled in the BDI. In part 2, a postal survey consisting the BDI was performed in 185 PD patients and 112 controls. Test-retest reliability was assessed in 60 PD patients. The factor analysis revealed a cognitive-affective and a somatic factor. Cronbachs alpha for the BDI was 0.88. Mean BDI indicated significant differences (P<0.001) between the PD and control group, between the PD-ND and PD-D group, and between PD-ND and control group. In part 1, the receiver operating characteristic curves showed that the area under the curve for the total BDI was 0.88. A cutoff was calculated for the BDI (14/15) that had the highest sum of sensitivity (0.71) and specificity (0.90). In part 2, the test-retest reliability for the BDI total score was 0.89 (intraclass correlation coefficient). The smallest real difference was 3.3 for the total BDI. The BDI is a valid, reliable, and potential responsive instrument to assess the severity of depression in PD. However, an adjusted cutoff is recommended.


Available from: Johan Marinus
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    • "To minimize inter-rater variability, only three clinically experienced raters were used for these tests at all visits. During the baseline visit and at the 48-week visit, participants filled out the PDQ-39 questionnaire [25], which is a disease-specific measure of subjective health status, and the Beck Depression Inventory [26], an instrument to assess the severity of depression. In addition, at the baseline visit participants completed a brief demographic survey, and at week 48, participants filled out a brief post-exercise program survey. "
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    ABSTRACT: Parkinson's Disease (PD) is a progressive neurodegenerative disease. Increasing evidence shows that physical exercise is beneficial for motor and non-motor symptoms of PD, and animal models suggest that it may help slow progression of disease. Using a randomized delayed-start design, 31 patients were randomized to an early start group (ESG) or a delayed start group (DSG) exercise program. The ESG underwent a rigorous formal group exercise program for 1 h, three days/week, for 48 weeks (November 2011-October 2012). The DSG participated in this identical exercise program from weeks 24-48. Outcome measures included the Unified Parkinson's Disease Rating Scale (UPDRS), Walking Test (get-up-and-go), Tinetti Mobility Test, PDQ-39 Questionnaire, and the Beck Depression Inventory. There was minimal attrition in this study, with only one patient dropping out. Results did not show improvement in total UPDRS scores with early exercise. At week 48, the mean change from baseline total UPDRS score was 6.33 in the ESG versus 5.13 in the DSG (p = 0.58). However, patients randomized to the ESG scored significantly better on the Beck Depression Inventory, with a mean improvement of 1.07 points relative to those in the DSG (p = 0.04). The findings demonstrate that long-term, group exercise programs are feasible in the Parkinson's disease population, with excellent adherence and minimal drop out. While the outcome measures used in our study did not provide strong evidence that exercise has a neuroprotective effect on motor function, earlier participation in a group exercise program had a significant effect on symptoms of depression.
    Parkinsonism & Related Disorders 10/2013; 20(1). DOI:10.1016/j.parkreldis.2013.10.003 · 3.97 Impact Factor
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    • "Previous findings in PD patients have shown an association between on/off states, fluctuations of mood and anxiety symptoms [47], and a potential negative influence of affective disorders on cognitive performance [48] [49]. Therefore, the State and Trait Anxiety Inventory-State Anxiety (STAY-S) [50] and the Beck Depression Inventory (BDI) [51] [52] were administered to both PD and healthy participants in the two experimental sessions. "
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    ABSTRACT: previous data suggest that i) dopamine modulates the ability to implement non-routine schemata and updating operations (flexibility processes) and that ii) dopamine-related improvement may be related to baseline dopamine levels in target pathways (inverted U-shaped hypothesis). to investigate above hypotheses in individuals with Parkinson's disease (PD). twenty PD patients were administered tasks varying as to flexibility load in two treatment conditions: i) "off" condition, about 18~hours after dopamine dose; ii) "on" condition, after dopamine administration. PD patients were separated into two groups: low performers (i.e., performance on Digit Span Backward below the sample mean) and high performers (i.e. performance above the mean). Twenty healthy individuals performed the tasks in two sessions without taking drugs. passing from the "off" to the "on" state, only low performer PD patients significantly improved their performance on high-flexibility measures (interference condition of the Stroop test; p< 0.05); no significant effect was found on low-flexibility tasks. these findings document that high-flexibility processes are sensitive to dopamine neuromodulation in the early phases of PD. This is in line with the hypothesis that striatal dopamine pathways, affected early by PD, are precociously implicated in the expression of cognitive disorders in these individuals.
    Behavioural neurology 09/2013; 2014(16). DOI:10.3233/BEN-130354 · 1.45 Impact Factor
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    • "Nevertheless, a recent large-scale study (Trenkwalder et al. 2011a) in patients selected for having unsatisfactory early morning motor-symptom control at any PD stage, with or without levodopa, constitutes the first double-blind, placebo-controlled investigation of the effects of a CDD strategy on both motor and nonmotor deficits. At 12 weeks, mean early morning motor dysfunction, mean sleep disturbance, and depressive symptomatology [as measured by UPDRS (Fahn et al. 1987), the PD sleep scale (PDSS) (Trenkwalder et al. 2011b), and the Beck depression inventory (BDI) (Visser et al. 2006), respectively] showed significantly greater improvements in the active-treatment group. Rotigotine has been re-introduced in the US market as a new formulation that may be more stable than the original. "
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    ABSTRACT: The complications of long-term levodopa therapy for Parkinson's disease (PD) include motor fluctuations, dyskinesias, and also nonmotor fluctuations-at least equally common, but less well appreciated-in autonomic, cognitive/psychiatric, and sensory symptoms. In seeking the pathophysiologic mechanisms, the leading hypothesis is that in the parkinsonian brain, intermittent, nonphysiological stimulation of striatal dopamine receptors destabilizes an already unstable system. Accordingly, a major goal of PD treatment in recent years has been the attainment of continuous dopaminergic stimulation (CDS)-or, less theoretically (and more clinically verifiable), continuous drug delivery (CDD). Improvements in the steadiness of the plasma profiles of various dopaminergic therapies may be a signal of progress. However, improvements in plasma profile do not necessarily translate into CDS, or even into CDD to the brain. Still, it is reassuring that clinical studies of approaches to CDD have generally been positive. Head-to-head comparative trials have often failed to uncover evidence favoring such approaches over an intermittent therapy. Nevertheless, the findings among recipients of subcutaneous apomorphine infusion or intrajejunal levodopa/carbidopa intestinal gel suggest that nonmotor PD symptoms or complications may improve in tandem with motor improvement. In vivo receptor binding studies may help to determine the degree of CDS that a dopaminergic therapy can confer. This may be a necessary first step toward establishing whether CDS is, in fact, an important determinant of clinical efficacy. Certainly, the complexities of optimal PD management, and the rationale for an underlying strategy such as CDS or CDD, have not yet been thoroughly elucidated.
    Journal of Neural Transmission 03/2013; 120(9). DOI:10.1007/s00702-013-0981-5 · 2.40 Impact Factor
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