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Ask the Mental Health Expert Archives 2001-2004

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Beck Depression Inventory

Q. My facility currently uses the Beck questionnaire to assess for depression with cardiac rehabilitation patients. Can nurses administer this questionnaire or is it better to have a psychiatric professional administer it?

A. The Beck Depression Inventory (BDI) is a self-completed scale that comes in a short and a long version. The BDI is the most widely used self-rating instrument for depressive symptoms. On the longer, 21-item BDI, a score of 17-29 would be considered moderate depression; greater than 30, severe. The issue is not really who can administer the test, since it is self-completed (unlike, say, the Hamilton Depression Inventory, which requires a clinician's input and observations). The real issue is, "Who should interpret the BDI?" and what are the medico-legal implications if the right staff do not interpret it?

>For example, one of the items on the BDI screens for suicidal ideation and intentions. If the patient indicates that he or she has had thoughts about suicide, I believe it is imperative that the individual be evaluated in detail by a mental health professional. That might be a clinical psychologist, psychiatric social worker, or psychiatrist. So, at a minimum, I think your staff should be alerted to the need to monitor that item, and to consider a psych consult if there is any question of significant suicidal intentions or plans.

April 2002

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