Hiroe T, Kojima M, Yamamoto I, et al. Gradations of clinical severity and sensitivity to change assessed with the Beck Depression Inventory-II in Japanese patients with depression

Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Mizuho-ku, Nagoya, 467-8601, Japan.
Psychiatry Research (Impact Factor: 2.47). 07/2005; 135(3):229-35. DOI: 10.1016/j.psychres.2004.03.014
Source: PubMed


Knowledge of what constitutes a minimal clinically important difference and change on a psychiatric rating scale is essential in interpreting its scores. The present study examines the Beck Depression Inventory-II (BDI-II), a recently revised successor to the world's most popular self-rating instrument for depression. BDI-II was administered to 85 patients with major depression, diagnosed with DSM-IV along with its severity specifiers. It was again administered to 40 first-visit patients from the original sample when they returned 14 or more days later. The Clinical Global Impression-Change Scale was rated at the same time. All the ratings were done independent of each other. The BDI-II was able to distinguish between all grades of depression severity. An approximate 10-point difference existed between each severity specifier. The BDI-II was also sensitive to change in depression: a 5-point difference corresponded to a minimally important clinical difference, 10-19 points to a moderate difference, and 20 or more points to a large difference. Given the already established high reliability, content validity, construct validity and factorial validity, and the high sensitivity to between-subject differences and within-subject changes demonstrated in the present study, the BDI-II promises to continue to be a leading self-rating instrument to assess depression severity worldwide.

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    • "Beck Depression Inventory – II (BDI-II) The Beck Depression Inventory – II (BDI-II) is a 21-item self-report inventory that measures depressive symptoms such as sadness, pessimism, suicidal thoughts or wishes, tiredness or fatigue, loss of energy, and loss of pleasure, among others (Beck et al. 1996; Hiroe et al. 2005 "
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    ABSTRACT: Background: In this study we investigated whether an Internet-based computerized cognitive behavioral therapy (iCBT) program can decrease the risk of DSM-IV-TR major depressive episodes (MDE) during a 12-month follow-up of a randomized controlled trial of Japanese workers. Method: Participants were recruited from one company and three departments of another company. Those participants who did not experience MDE in the past month were randomly allocated to intervention or control groups (n = 381 for each). A 6-week, six-lesson iCBT program was provided to the intervention group. While the control group only received the usual preventive mental health service for the first 6 months, the control group was given a chance to undertake the iCBT program after a 6-month follow-up. The primary outcome was a new onset of DSM-IV-TR MDE during the 12-month follow-up, as assessed by means of the web version of the WHO Composite International Diagnostic Interview (CIDI), version 3.0 depression section. Results: The intervention group had a significantly lower incidence of MDE at the 12-month follow-up than the control group (Log-rank χ2 = 7.04, p < 0.01). The hazard ratio for the intervention group was 0.22 (95% confidence interval 0.06-0.75), when estimated by the Cox proportional hazard model. Conclusions: The present study demonstrates that an iCBT program is effective in preventing MDE in the working population. However, it should be noted that MDE was measured by self-report, while the CIDI can measure the episodes more strictly following DSM-IV criteria.
    Psychological Medicine 01/2015; 45(09):1-11. DOI:10.1017/S0033291714003006 · 5.94 Impact Factor
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    • "In addition, the Japanese version of the self-report Y-BOCS [35] was administered for the participants with OCD; individuals were included if they scored over 16 points (the suggested cut-off for OCD). To confirm that potential OCD participants had no panic disorder or depression symptoms, the Japanese version of the Self-Report PDSS (PDSS-SR-J) [36] and Japanese version of the Beck Depression Inventory, Version II (BDI-II) [37] were administered; individuals were excluded if they scored over the cut-off point (minimal symptoms vs. mild symptoms) of 8 for the PDSS-SR-J [36] and 14 for the BDI-II [38]. The final OCD group consisted of 35 individuals (OCD group; male = 12, female = 23; age range: 20–48 years, M = 30.11, "
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    ABSTRACT: Background The Obsessive-Compulsive Inventory (OCI) was designed to evaluate the severity of obsessive-compulsive symptoms in both clinical and non-clinical samples. The aim of the study was to develop a Japanese version of this scale (OCI-J) and validate it in both non-clinical and clinical Japanese samples. Findings In Study 1, the OCI-J, the Maudsley Obsessional Compulsive Inventory (MOCI), and measures of anxiety and depression were administered to 150 undergraduate students (non-clinical sample) in order to investigate the internal consistency and convergent validity of the OCI-J. Furthermore, 118 non-clinical participants completed the OCI-J after a 2-week interval to determine the test-retest reliability. In Study 2, OCD participants (n = 35), anxiety control participants with panic disorder (n = 22), and healthy control participants (n = 37) completed the OCI-J in order to test its clinical discrimination ability. Correlational analysis indicated moderate to high correlations between the subscales and total scores of the OCI-J and MOCI. In addition, the OCI-J and its subscales demonstrated satisfactory test-retest reliabilities. Finally, the OCI-J showed good clinical discrimination for patients with OCD from healthy and anxiety controls. Conclusions The OCI-J is a valid and reliable instrument for measuring OCD symptoms in both clinical and non-clinical samples of Japanese.
    BMC Research Notes 05/2014; 7(1):306. DOI:10.1186/1756-0500-7-306
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    • "Nous pouvons faire l'hypothèse qu'un nombre plus important de stimulations aurait conduit à un bénéfice thérapeutique plus important [36]. Enfin, l'utilisation d'un autoquestionnaire pour évaluer l'intensité de la dépression peut nous être reprochée, toutefois plusieurs études ont démontré une forte validité convergente entre BDI-II et Hamilton Depression Rating Scale ou la Clinical Global Impression [37] [38]. "
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    ABSTRACT: Major depressive disorder remains one of the leading causes of disability in developed countries despite pharmacological and psychological treatments. Patients with major depression have poorer health-related quality of life than persons of the general population, or patients with chronic somatic illness. Improvement of health-related quality of life in depression is thus a pertinent treatment objective. Both high-frequency repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex and low-frequency rTMS over the right dorsolateral prefrontal cortex have shown their effectiveness in medication-resistant depression. However, the Health-related Quality of Life questionnaire remains under-utilized to assess the effectiveness of rTMS in research or in a routine clinical setting. Our study aims to investigate in an open label trial the efficacy of low-frequency rTMS over the right dorsolateral prefrontal cortex on health-related quality of life and clinical outcomes in medication-resistant depression. In a naturalistic trial, 33 unipolar and bipolar patients with medication-resistant depression were treated with daily low-frequency rTMS over the right dorsolateral prefrontal cortex for 4 weeks. Health-related quality of life was assessed using the SF-36 questionnaire. The SF-36 is a generic, self-administered, and worldwide-used questionnaire, consisting of 36 items describing eight health dimensions: physical functioning, social functioning, role-physical problems, role-emotional problems, mental health, vitality, bodily pain, and general health. Physical component summary and mental component summary scores were then obtained. Depression severity was assessed using the 21-item self-report Beck Depression Inventory. Anxiety severity was assessed using the State-Trait Anxiety Inventory. The SF-36, the Beck Depression Inventory and the State-Trait Anxiety Inventory were assessed before and after low-frequency rTMS. The effect of rTMS treatment on the SF-36 and the clinical outcome was evaluated for significance with the Wilcoxon two-tailed signed-rank test. The reliable change index (RCI) was calculated to determine clinically significant change in the eight dimension and composite scores of the SF-36 from pre-intervention to post-intervention, at the level of individual patients. Effect size (r) was then calculated, r values from 0.1 to 0.29, 0.3 to 0.49 and from 0.5 were considered as indicating small, medium and large effect sizes, respectively. Correlations between improvement in Health-related Quality of Life and improvement in the other rating scale scores were calculated using Spearman's correlation test. There were significant improvements of 37.6 % in the mental health (P=0.018), 130 % in the role-emotional problem (P=0.045), 15.5 % in the physical functioning (P=0.008), 110.6 % in the role-physical problem (P=0.002), 22.4 % in the bodily pain (P=0.013) dimensions, 6.1 % in the Physical Component Score (P=0.043), and 22,5 % in the Beck Depression Inventory (P=0.002). Eighteen patients (54 %) showed clinically significant improvement in one of the two composite scores after RCI calculation. Seven out of the eight SF-36 dimension scores and the two composite scores showed effect sizes ranging from 0.12 to 0.38, indicating small to moderate effect. Significant correlations were found between improvement in the Beck Depression Inventory and improvement in the Mental Component Score, the social functioning, the mental health, the general health, the vitality and the physical functioning dimensions. Small sample size and non-controlled design. Low-frequency rTMS over the right dorsolateral prefrontal cortex improves Health-related Quality of Life in unipolar and bipolar patients with medication-resistant depression. Improvement in mental health-related quality of life is significantly correlated with improvement in depressive symptoms. However, further studies with larger samples and controlled designs are needed to clarify our findings.
    L Encéphale 09/2013; · 0.70 Impact Factor
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