Highlights
- The Beck Depression Inventory (now known as the BDI-II) is a clinical self-report questionnaire that measures the core symptoms of depression.
- Your healthcare provider may use the BDI-II to screen for depression symptoms and refer you to treatment if needed. You can also take and score the BDI-II yourself.
- Although research has found the BDI-II to be reliable, no clinical tool can diagnose depression when used on its own. If you think you may be experiencing depression, it’s important to see a licensed mental health provider to get assessed.
Depression is one of the most common mental health conditions, both globally and in the U.S. Fortunately, it can be treated. But to get the right treatment, you need an accurate diagnosis. The Beck Depression Inventory (BDI) is one clinical tool that providers use to diagnose depression.
Although there are many tools that can be used to diagnose depression, the BDI is the most widely used. This tool helps clinicians understand whether your symptoms are a sign of depression, and whether you require treatment.
In this article, we’ll walk you through the Beck Depression Inventory, including what, exactly, it measures and how to use it.
What Is Beck's Depression Inventory?
The Beck Depression Inventory is a multiple-choice questionnaire that helps mental health providers assess patients for depression.
Dr. Aaron T. Beck, a psychiatrist, developed the Beck Depression Inventory (BDI) in 1961. It can be used to evaluate the severity of depression symptoms. It’s also used over periods of time to track the effectiveness of treatment. If your BDI scores decline, this suggests that your symptoms are getting better.
The original BDI had 21 questions (also known as “items”), each representing a different symptom of depression. It was first revised in 1978; this version was known as the BDI-1A.
The newest and most current version — and the one we’re referring to in this article — is the BDI-II, which was published in 1996. The BDI-II was created in response to the new diagnostic criteria for major depressive disorder in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The previous version (BDI-1A) only tested for 6 out of the 9 new criteria. The BDI-II tests for all 9 core symptoms:
- Depressed mood
- Anhedonia (loss of interest and pleasure)
- Changes in appetite and weight
- Sleep issues (from insomnia to hypersomnia)
- Psychomotor changes (feeling either slowed down or restless)
- Low energy levels and fatigue
- Feelings of excessive guilt and worthlessness
- Trouble concentrating
- Thoughts of death
It’s important to note that the BDI (as well as any other clinical tool) is just one part of a comprehensive diagnostic assessment. Most providers don’t diagnose depression based on your BDI scores alone. But it can help to objectively measure how severe your symptoms are and how they change over time.
Items of BDI
Like the original version, the BDI-II also consists of 21 items. Each item has 4 answer choices. You must choose one, and only one, answer for each item. Choose the answer that best describes how you feel.
For example, on one item regarding “sadness”, the answer choices are:
- 0 — I do not feel sad.
- 1 — I feel sad.
- 2 — I am sad all of the time and I can’t snap out of it.
- 3 — I am so sad and unhappy that I can’t stand it.
You would need to choose the number that most accurately describes how you feel.
The items of BDI are divided into categories to evaluate 6 different groups of depression symptoms. These groups include:
- Affective: Symptoms that affect your mood, like sadness or emptiness.
- Cognitive: Symptoms that affect your thinking and mental processing, like whether you’re having a harder time concentrating or making decisions.
- Cognitive Distortions: These symptoms reflect negative or irrational thoughts you have about yourself or the world around you; for example, one item in this category asks about whether or not you feel like a failure.
- Physiological: Physical symptoms, like changes to appetite and sleep.
- Motivational: How energetic or motivated you feel about day-to-day activities, including things like work and your hobbies.
- Behavioral: How you’re acting; for example, if you’re crying a lot or becoming less productive at work.
The specific depression symptoms that the BDI measures are:
- Feeling sadness
- Pessimism or feeling discouraged about the future
- Feeling like a failure
- Loss of pleasure in activities you used to enjoy
- Feeling guilty
- Feeling like you’re being punished
- Self-loathing or disliking yourself
- Criticizing or blaming yourself
- Suicidal thoughts (thoughts about ending your life or wanting to die)
- Crying
- Being restless or agitated
- Loss of interest in other people or activities
- Indecisiveness or difficulty making decisions
- Feelings of worthlessness
- Loss of energy
- Changes in sleeping patterns
- Irritability
- Changes in appetite
- Difficulty concentrating
- Tiredness or fatigue
- Loss of sex drive or libido
These very closely match the official diagnostic criteria for depression that’s laid out in the most recent version of the DSM.
How to Administer BDI?
The BDI is a self-report inventory, which means that you’ll answer each item based on how much you feel it applies to yourself. This is in contrast with other types of questionnaires that are based on others’ observations of your symptoms.
A lot of the time, the BDI is administered and scored by a healthcare professional. They may hand you the questionnaire to fill out yourself (either digitally or with pen and paper), or they may read you the statements and record your answers.
You can also take and score the BDI by yourself. This can help you get some initial answers about whether or not your experiences could be due to depression. However, only licensed healthcare providers can diagnose mental health conditions. So just because you score a certain way on the BDI doesn’t mean that you can diagnose yourself with depression.
In general, all questionnaires and clinical instruments are best used in context, as just one part of a more comprehensive psychiatric assessment. Research has shown the BDI-II to be reliable. But that doesn’t mean that it’s 100% accurate 100% of the time. Also, note that the official BDI-II scale is copyrighted and available for clinicians with proper licensing who can conduct comprehensive mental health assessments. Online tests for depression resembling BDI-II may not be standardized diagnostic tools, they are provided for informational purposes only.
Regardless of what your results say, if you think you might be experiencing depression, it’s important to see a mental health provider directly.
Beck Depression Inventory Scoring
BDI scoring is straightforward. Every item has 4 answer options, and each answer option is attached to a number between 0 and 3. In general, selecting the first option from a multiple-choice question (zero) means you don’t experience the symptom. Selecting the last option (three) means you have serious difficulty with that particular symptom.
When you finish taking the test, your scores for each of the 21 items are added together. That means your results will range between 0 and 63. The higher your score, the more severe your depression symptoms.
Here is a guide to interpreting your BDI-II score.
Range of scores | The severity of depressive symptoms |
0 – 13 | No or minimal depression symptoms |
14 – 19 | Mild depression symptoms |
20 – 28 | Moderate depression symptoms |
29+ (29 – 63) | Severe depression symptoms |
What Can a BDI Score Tell You?
The BDI is often used for screening purposes. In other words, it can help identify people who may be experiencing depressive symptoms and could benefit from further evaluation by a healthcare provider.
The BDI (nor any other tool or questionnaire) can’t tell you for sure whether or not you have depression. It’s not enough for a diagnosis. To make a diagnosis, healthcare providers may use the BDI, along with other methods like:
- Clinical interview
- Observations of your symptoms
- Interviews with other people in your life
But the BDI can provide a starting point about whether your symptoms could be due to depression. If you take it multiple times, it can also tell you how your symptoms are changing (improving or worsening) over time.
What to Do After Your Result
If your BDI results indicated that you may be experiencing depression, then the next step is to talk to a licensed healthcare provider. Bring in a digital or printed copy of your responses and results. They can use your BDI in context when evaluating you for depression and other mental health conditions.
It’s essential to see a licensed provider because depression requires treatment. A diagnosis is only the first step. If your BDI results suggest that you have depression, a mental health professional can walk you through your treatment options and help you get connected with a psychiatrist, if required.
Most of the time, depression is treated with therapy, antidepressant medications, or a combination of both. If those first-choice treatments don’t work, there are other options, including other types of medications (like antipsychotics).
A provider can also recommend lifestyle changes that can help you manage depression symptoms. For example, physical exercise has been repeatedly shown in research to reduce depression, especially alongside treatment.
Although depression is chronic (can’t be fully cured), treatment can help you manage it. Many people with depression live happy and fulfilling lives with treatment and lifestyle changes.
Conclusion
The Beck Depression Inventory can be a useful way to understand what you’ve been experiencing. It gives you a clearer picture of your symptoms and how severe they might be. But it’s only one piece of the puzzle. A questionnaire can point you in the right direction, but it can’t replace a full evaluation with a licensed provider.
If your results suggest that you may be dealing with depression, the next step is to act on that information. With MEDvidi, you can connect with a licensed provider and begin personalized depression treatment online, often within 24 hours. Get started today.
Frequently Asked Questions
What is the BDI assessment?
The BDI, or Beck Depression Inventory, is a self-report questionnaire that’s used to measure the depression symptoms described in the DSM.
What is a normal BDI score?
There is no “normal” BDI score. According to the scoring guidelines, scores of 13 and lower suggest little to no depression. Scores 29 and higher indicate more severe depression.
How long does it take to complete the BDI?
The BDI only has 21 items. Most people are able to complete it in 5 to 10 minutes.
What does a high BDI score indicate?
Theoretically, the higher your BDI score, the more severe your depression symptoms. But keep in mind that no questionnaire can definitively determine whether or not you have depression.
Can you take a depression screening online?
Yes, you can take the BDI-II, as well as other depression tests like the Center for Epidemiologic Studies Depression Scale (CES-D), online. But you should always take your results to a mental health provider for interpretation.
