Factor structure and clinical utility of the Beck Depression Inventory in patients with binge eating disorder and obesity

Abstract

Objective The Beck Depression Inventory (BDI) is often used to assess depression symptoms, but its factor structure and clinical utility have not been evaluated in patients with binge eating disorder (BED) and obesity. Methods 882 treatment-seeking obese patients with BED were administered structured interviews (SCID-I/P) and completed self-report questionnaires. Results Exploratory and confirmatory factor analyses supported a brief 16-item BDI version with a three-factor structure (affective, attitudinal, and somatic). Both 21- and 16-item versions showed excellent internal consistency (both α=0.89) and had significant correlation patterns with different aspects of eating disorder psychopathology; three factors showed significant but variable associations with eating disorder psychopathology. Area under the curves (AUC) for both BDI versions were significant in predicting major depressive disorder (MDD; AUC=0.773 [16-item], 73.5% sensitivity/70.2% specificity, AUC=0.769 [21-item], 79.5% sensitivity/64.1% specificity) and mood disorders (AUC=0.763 [16-item], 67.1% sensitivity/71.5% specificity, AUC=0.769 [21-item], 84.2% sensitivity/55.7% specificity). 21-item BDI (cut-off score ≥16) showed higher negative predictive values (94.0% vs. 93.0% [MDD]; 92.4% vs. 88.3% [mood disorders]) than brief 16-item BDI (cut-off score ≥13). Conclusions Both BDI versions demonstrated moderate performance as a screening instrument for MDD/mood disorders in obese patients with BED. Advantages and disadvantages for both versions are discussed. A three-factor structure has potential to inform the conceptualization of depression features.

Emotion‐focused therapy for binge‐eating disorder: A review of six cases

“…Many individuals with BED have comorbid emotional disorders (Dingemans, Danner, & Parks, 2017) including anxiety (Becker et al, 2017;Blomquist & Grilo, 2015) and depression (Araujo, Santos, & Nardi, 2010;Udo, McKee, & Grilo, 2015). Bruch (1964) initially suggested a relationship between emotions and overeating, and difficulties in emotion regulation have been identified as an antecedent of many eating disorder behaviours, including binge eating (Lawson, Emanuelli, Sines, & Waller, 2008;Leehr et al, 2015).…”

Smoking status and psychosocial factors in binge eating disorder and bulimia nervosa

“…The BDI has demonstrated strong reliability and validity in adult clinical and community-based samples (Beck, Steer, & Carbin, 1988). The BDI also has support as a screening measure for mood disorders in individuals with binge eating disorder (Udo, McKee, & Grilo, 2015). …”

The Relationship between Depression and Severe Obesity: A Case-Control Study

“…Furthermore, Castellini et al [29] demonstrated that the BDI had high prevalence rates when symptoms of depression and anxiety were present. Researchers [30] have used the BDI to assess depression symptoms in binge eating and obesity groups. They used both 21-and 16-item versions of the Fourth Edition Axis I Disorders.…”