How to score Beck Depression Inventory 2 | Headway

What is the Beck Depression Inventory?

The Beck Depression Inventory is a self-assessment questionnaire created to identify the presence and severity of major depressive disorder. Therapists and other providers can use it as a tool to diagnose depression, along with tracking the progress of depression symptoms over time. Thanks to its simplicity and efficiency, the Beck Depression Inventory is one of the most widely used assessment tools for depression.

The BDI was first published in 1961. In 1996, the BDI was revised to the current BDI-II to better align with the DSM criteria for major depressive disorder. The BDI-II also asks respondents how they have felt over the last two weeks rather than at the time of the test. These changes may allow for a more accurate diagnosis and, as a result, appropriate treatment for a client with depression.

Understanding the structure

The Beck Depression Inventory includes 21 questions with four multiple-choice answers. For each question, respondents choose the answer that best represents their experience over the last two weeks, including the day of the assessment.

After the respondent finishes the test, the therapist calculates a score that can help support or rule out a depression diagnosis (or better understand the severity of current symptoms in someone already diagnosed with depression).

How to interpret the Beck Depression Inventory scoring system

Each of the 21 questions on the Beck Depression Inventory has a multiple-choice answer that’s scored from 0-3. It yields a total score between 0-63, which indicates symptom severity (ranging from minimal, mild, moderate, or severe).

The higher the score, in general, the more severe a person’s symptoms will be. Use the following guidelines when scoring and interpreting your client’s results:

0-13 (Minimal depression): This score range represents minor depression symptoms, which could be part of typical mood variations or reactions to a person’s life events.
14-19 (Mild depression): This score range represents either persistent sub-threshold depression symptoms or the onset of a new depressive episode. While symptoms may not be severe, they can still impact the respondent’s quality of life.
20-28 (Moderate depression): This score range represents the presence of several depression symptoms that affect the respondent’s activities in a substantial way.
29-63 (Severe depression): This score range represents a high level of depression symptoms, which suggests a severe depressive disorder. People who score in this range may be experiencing significant distress and functional impairment.

How to use the Beck Depression Inventory in your practice

The Beck Depression Inventory is best used for clients aged 13 and above. It’s a great tool to use during an intake session to establish a baseline and develop a treatment plan for a client with depression. You can also use the BDI-II during treatment to track a client’s progress and adjust your treatment if needed. It can be completed and scored on paper or electronically.

Along with a clinical interview, you may want to use other assessment tools for a clearer view of your client’s experience. For example, the WHO-5 is another popular assessment tool therapists use to screen for symptoms of depression and overall well-being.

Understanding the validity and reliability of the results

In general, the BDA is a reliable and valid measure of a person’s depression symptoms. One study found the BDI-II’s test-retest reliability — how consistent scores are over time — ranged from 0.73 to 0.96. The same study found the internal consistency of the BDI-II’s was 0.9, implying the questions on the assessment relate to one another and measure the same thing.

Limitations of the Beck Depression Inventory to consider

The Beck Depression Inventory is a helpful tool to support a diagnosis of major depressive disorder, but keep in mind it’s not a diagnostic tool in and of itself. The BDI is a self-report measure, so it asks respondents to rate their own perception of their symptoms. Some respondents may have trouble accurately recognizing and reporting their depression symptoms.

The Inventory also only assesses depression symptoms over the last two weeks. It can’t identify a person’s risk factors for depression, such as traumatic experiences and a family history of depression. Conducting a full assessment to better understand your client’s biopsychosocial history — along with their current depression symptoms — is the best way to determine the appropriate diagnosis.

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