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Comparing the Beck Depression Inventory-II (BDI-II) and Patient Health Questionnaire (PHQ-9) Depression Measures in an Outpatient Bariatric Clinic

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Abstract

Background

Screening for depressive symptoms is important when evaluating bariatric surgery candidates, as worse outcomes can be seen with higher pre-surgical and post-surgical psychiatric comorbidities. The Beck Depression Inventory-II (BDI-II) and Patient Health Questionnaire (PHQ-9) are two widely used depression screening instruments. This study evaluated whether both instruments have similar performance in an outpatient bariatric surgery clinic setting.

Methods

One thousand thirty-four bariatric surgery candidates completed both PHQ-9 and BDI-II whose scores were analyzed in this retrospective study. Spearman’s correlation coefficient was calculated to compare total scores on each instrument. PHQ-9 categories were compared to corresponding BDI-II categories via several different methods. Weighted kappa coefficients were calculated for (1) PHQ-9 and BDI-II categories, (2) scores ≥10 on the PHQ-9 and ≥20 on the BDI-II, and (3) the specific item of suicidality.

Results

Spearman’s correlation was strong at 0.74. The median PHQ-9 and BDI-II scores were 5 and 9, corresponding to the mild and minimal categories, respectively. Weighted kappa analysis demonstrated a moderate association between depressive symptom categories evaluated using three methods. A moderate to substantial association was found for the suicidality item, with agreement of 92.3 %.

Conclusions

PHQ-9 and BDI-II scores in patients seeking bariatric surgery are closely correlated. Categories of depressive symptom severity and responses to suicidality showed moderate to substantial agreement. When choosing an appropriate depression screening tool, these findings support the use of the PHQ-9 as a viable alternative to the BDI-II in patients seeking bariatric surgery.

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Acknowledgments

This study was supported by Grant Number UL1 TR000135 from the National Center for Advancing Translational Sciences (NCATS). The contents of this study are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.

Conflict of Interest

The authors declare that they have no competing interests.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Informed consent does not apply.

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Authors and Affiliations

  1. Department of Psychiatry and Psychology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA

    Paul E. Schutt, Simon Kung, Matthew M. Clark, Afton M. Koball & Karen B. Grothe

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  1. Paul E. Schutt
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  2. Simon Kung
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  3. Matthew M. Clark
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  4. Afton M. Koball
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  5. Karen B. Grothe
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Correspondence to Simon Kung.

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Schutt, P.E., Kung, S., Clark, M.M. et al. Comparing the Beck Depression Inventory-II (BDI-II) and Patient Health Questionnaire (PHQ-9) Depression Measures in an Outpatient Bariatric Clinic. OBES SURG 26, 1274–1278 (2016). https://doi.org/10.1007/s11695-015-1877-2

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  • DOI: https://doi.org/10.1007/s11695-015-1877-2

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