Beck Depression Scale: questionnaire methodology, interpretation of results and assessment of psychological state

One of the human mental disorders is depression. Signs of the disorder include sleep disturbance, decreased appetite, depression, apathy, impaired concentration, slow thinking and other signs. Depression can develop as a result of severe stress, illness, or when taking certain medications. Endogenous depression develops without the influence of certain negative factors and has no obvious cause; somatogenic depression is based on various diseases; psychogenic depression is based on stress caused by various life situations. Depression can cause the development of suicidal tendencies and lead to the development of alcoholism and drug addiction. To determine the degree of development of depression in a patient, tests are used, including the Beck Anxiety Inventory (Beck Depression Inventory).

The Beck Anxiety Scale and Zang Scale are used to screen a patient’s depressive state; the diagnosis is made by psychiatrists. The Yusupov Hospital treats depressive conditions and diagnoses mental disorders using various techniques. Yusupov Hospital is a modern multidisciplinary medical center, which includes several multidisciplinary clinics, a diagnostic center, a laboratory, a hospital, and a rehabilitation center. The hospital provides physiotherapeutic procedures, massages, and offers patients comfortable rooms with all amenities.

During the test, typical manifestations of a mental disorder are revealed. All types of depression manifest themselves with typical symptoms:

Depressive state - depression, bad mood, depressed state.
Mental retardation - poor emotions, lack of initiative, fatigue, passivity, decreased appetite, preoccupation with one's own fears, loss of interest in people.
Motor retardation - slow speech, slow movement, the patient lies more, often without changing posture, selects the answer to the question for a long time.

The difference between the psychogenic form of depression:

Depression is preceded by a stressful situation.
The state of health worsens after a repeat of the stressful situation.
Depression worsens in the evening.
Symptoms of depression disappear after the stressful situation ends.

Endogenous depression does not have a previous trauma to the mental disorder, manifests itself with symptoms traditional for all types of depression, and is difficult to diagnose. Symptoms of an endogenous depressive state can appear in adolescents and people over 40 years of age; the patient’s condition worsens in the morning. Unlike the psychogenic form of the disorder, which is treated with psychotherapy, the endogenous disorder is treated with medication. After passing the test, the doctor asks additional questions and assesses the patient’s state of thinking - this helps to make a correct diagnosis.

Description of the technique

Beck Depression Inventory

(Beck Depression Inventory) proposed by A.T. Beck in 1961 and developed on the basis of clinical observations, which made it possible to identify a limited set of the most relevant and significant symptoms of depression and the most frequently reported complaints by patients. After correlating this list of parameters with clinical descriptions of depression contained in the relevant literature, a questionnaire was developed that included 21 categories of symptoms and complaints. Each category consists of 4-5 statements corresponding to specific manifestations/symptoms of depression. These statements are ranked according to the increasing specific contribution of the symptom to the overall severity of depression.

In accordance with the severity of the symptom, each item is assigned values from 0 (the symptom is absent or minimally expressed) to 3 (the maximum severity of the symptom). Some categories include alternative statements of equivalent weight.

In the original version, the method was completed with the participation of a qualified expert (psychiatrist, clinical psychologist or sociologist), who read each item from the category out loud, and then asked the patient to choose the statement that most corresponds to his current condition. The patient was given a copy of the questionnaire, according to which he could follow the items read by the expert. Based on the patient's response, the researcher marked the appropriate item on the form. In addition to the test results, the researcher took into account anamnestic data, indicators of intellectual development and other parameters of interest.

Currently, it is believed that the testing procedure can be simplified: the questionnaire is given to the patient and filled out independently.

The score for each category is calculated as follows: each item on the scale is scored from 0 to 3 according to the increasing severity of the symptom. The total score ranges from O to 62 and decreases in accordance with the improvement of the condition.

Test yourself for depression using the Beck Depression Scale

Below are groups of statements. Each statement has four answer options. Choose the one that best describes how you have felt over the past week, including today. Points are added up automatically.

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Beck Depression Inventory

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Procedure

Instructions

“This questionnaire contains groups of statements. Read each group of statements carefully. Then identify one statement in each group that best matches how you felt THIS WEEK AND TODAY. Check the box next to the statement you selected. If several statements from one group seem equally good to you, then check the box next to each of them. Make sure you read all statements in each group before making your choice."

Possibilities and application features

The depression scale developed by Beck, internationally known as the Depression Inventory by Beck, is used to test for the presence of depressive mental disorders in adolescents and adults. The BDI-II version is used to test individuals aged 13 years and older. There are three versions of the questionnaire.

The first appeared in 1961, the second revised version of BDI-1A was published in 1978. Today, the version of the BDI-II, which was published in 1996, is used in psychiatric practice. The depression scale is used to determine the patient’s psycho-emotional background, the presence of deviations from the norm and the degree of their severity.

Difficulties in using the Beck Depression Inventory may arise if those tested have cognitive impairment and an anxiety disorder, which negatively affects the productivity of intellectual activity. In such cases, patients are slow to understand the Beck Depression Scale questions and instructions for interpreting the results.

Often, loss of strength, worsening mood and decreased motivation become the reason for refusing testing. Under pressure from loved ones, patients may continue to answer questions formally, which leads to random results that do not correspond to reality.

Processing and interpretation of results

When interpreting the data, the total score for all categories is taken into account.

Adult version of the questionnaire

Total score

0-9 – absence of depressive symptoms
10-15 – mild depression (subdepression)
16-19 – moderate depression
20-29 – severe depression (moderate)
30-63 – severe depression

Subscales

Items 1-13 – cognitive-affective subscale (CA)
Items 14-21 – subscale of somatic manifestations of depression (SP)

Individual symptoms

It is also possible to separately assess the severity of 21 symptoms of depression:

Mood
Pessimism
Feeling of inadequacy
Dissatisfaction
Guilt
I feel like I'll be punished
Self-loathing
Self-blame ideas
Suicidal thoughts
Tearfulness
Irritability
Disruption of social connections
Indecisiveness
Body image
Loss of performance
Sleep disturbance
Fatigue
Loss of appetite
Weight loss
Involvement in bodily sensations
Loss of libido

Teen version of the questionnaire

Up to 9 points, satisfactory emotional state - 4 points,
From 10 to 19 points, mild depression - 3 points
From 19 to 22 points moderate depression - 2 points
More than 23 points severe depression - 1 point

A depression level of 19 is considered clinically impaired; a level above 24 points indicates the need for therapy, possibly with the use of antidepressants. The goal of treatment should be to achieve a depression level below 10 points.

What to do if the test indicates a problem?

Beck Depression Scale: How to self-diagnose Photo: Depositphotos
It all depends on the degree of depression. If it is not dangerous according to the Beck scale, you can try to correct the situation yourself.

Get a good night's sleep. Usually, depression suffers from insomnia, so it is important to establish a daily routine: get up and go to bed at the same time. Gradually the body will get used to it. Before going to bed, the room must be well ventilated, ensure complete darkness and silence. Remember that in a depressed state, the body needs more time to rest. If your usual norm is 8 hours of sleep, increase it to 9-10 hours.
Move more. When you're depressed, you don't want to do anything. But the trick is that it is physical activity that helps relieve this condition. Start with a regular walk - preferably in places where you like. Gradually increase the load - try to go up and down the stairs on foot, even if you have an elevator. Ride a bike, go to the pool - anything that gets you moving will do.
Eat well. Not only your well-being, but also your mood depends on your menu. Therefore, your diet must include foods rich in vitamins, minerals and amino acids. These are vegetables, fruits, berries, lean meat, fish, herbs, nuts, cottage cheese, kefir, eggs, cereals. Eliminate or minimize fast food, sugary carbonated drinks, processed foods and sweets from your menu.
Get as much daylight as possible. Its deficiency often leads to depression - especially in autumn and winter. Open the curtains during the day, or even better, try to walk at least a little. Provide good lighting to keep the room as bright as possible in the evening. LED lamps are a good solution, they are bright and consume little electricity.
New impressions and emotions help to abstract from the negative. It could be an interesting movie, get-togethers with friends, or any event. Even if you’re not in the mood, force yourself – the effect is worth it.
Support from loved ones is a must. Don't give up on it. It's easier to deal with problems with someone's help. In addition, a loved one will make sure that you do not go hungry - this is important for recovery.

If you approach the situation consciously and follow these simple recommendations, your emotional state will soon return to normal.

But if the Beck Depression Inventory shows serious distress or home preventive measures do not work, consult a doctor immediately. Only he can prescribe effective treatment based on the test results.

Material prepared by: Inna Klevacheva Cover photo: Depositphotos

Beck Questionnaire

In the basic version, the depression scale is presented in the form of 21 signs of a depressive state. They are divided according to the level of manifestations of the disease in the subject’s condition. In practice, these are two groups: the affective-cognitive scale and somatic manifestations. In principle, there are no particular difficulties in completing the questionnaire on your own.

You can take the Beck Depression Test online right now (you must select one answer):

State of the day.

A) sadness.

B) disorder.

C) stable sadness and sadness.

D) impossible frustration and melancholy.

State of the week.

A) I don’t think about the future.

B) I feel that I am puzzled by the future.

C) there is no confidence that a good future awaits.

D) the future is hopeless.

Status.

A) I am a lucky person.

B) I have more successes than failures.

C) I experience more failures than successes.

D) I admit that I am an unlucky person.

Satisfaction.

A) I feel completely satisfied with life.

B) I don’t get enough pleasure.

C) I am more often not satisfied with the results of my own actions.

D) tired of living from a feeling of absolute dissatisfaction.

Guilt.

A) there is nothing to reproach yourself with.

B) sometimes there is a slight feeling of guilt.

C) it’s often my fault.

D) the soul is gnawing at guilt in all actions and deeds.

Punishment.

A) there is nothing to punish me for.

B) I am preparing to be punished for some actions.

C) I often expect punishment.

D) all my life I have felt like a punished person.

Disappointment.

A) I have never been disappointed in myself.

B) occasionally notes of disappointment are present in thoughts.

C) more often you have to be disappointed in yourself and people.

D) complete disappointment with life and with oneself.

Self-esteem.

A) I am the best creature on the planet.

B) I criticize myself for minor mistakes and shortcomings.

C) I blame myself for all serious offenses.

D) everything bad happened only through my fault.

Suicide.

A) I love life and want to live.

B) in a fit of passion, he wanted to end this world.

C) there was a repeated desire to commit suicide.

D) even now I can commit suicide.

Tears.

A) I don’t cry and don’t recommend it to anyone.

B) tears come more often than usual.

C) I cry constantly.

D) I’m sobbing inside, but I can’t physically cry anymore.

Irritability.

A) nothing irritates you more than the standard.

B) I notice that irritability has increased.

C) irritation is my middle name most days.

D) I feel irritable all day long.

Sociality.

A) there is an interest in other people.

B) I show less interest in society.

C) I am more interested in myself.

D) there is no interest in society.

Determination.

A) I make decisions quickly and clearly.

B) I notice doubts when making decisions.

C) the decision is very difficult to make.

D) there is no desire to make any decisions at all.

Physical condition of the body.

A) the body looks decent.

B) I often try to correct defects in appearance.

C) I just work on my body.

D) I look terrible, and nothing can help me.

Job.

A) I enjoy working and working.

B) I work, but without feeling happy.

C) I force myself to act under pressure.

D) I can’t do even basic work.

Dream.

A) I sleep well and get enough sleep.

B) sometimes suffer from nightmares and insomnia.

C) I wake up several times during the night and can’t fall asleep right away.

D) unstable sleep, chronic insomnia.

Fatigue.

A) I get tired at the end of the day.

B) I get tired after lunch.

C) I feel tired in the morning.

D) a constant feeling of total fatigue.

Appetite.

A) I eat regularly and stick to a routine.

B) sometimes the appetite disappears.

C) the desire to snack is practically absent.

D) I have no appetite for a long time.

Weight.

A) weight changes slightly.

B) constant changes in weight, but I don’t attach any importance to this.

C) I’m worried about my weight, but I’m trying to regulate it.

D) I’m constantly trying to lose weight and therefore I eat almost nothing.

Health.

A) rarely worries about health.

B) minor disturbances often occur: pain, constipation, discomfort.

C) I often go to the clinic.

D) I think only about my health and nothing else.

Sex.

A) I have sex when I want to.

B) I’m interested in sex a little less than before.

C) I almost lose interest in sex.

D) the desire to have sex is completely lost.

The specialist recommends keeping diaries of your condition regularly so that when you visit a specialist, the picture is extremely clear. This questionnaire for major depression is not a doctor, but only an assistant. If you need to get rid of a disease of the nervous system or similar disorders, you can contact a professional psychologist, for example, Nikita Valerievich Baturin.

Physiological signs

Among the physiological signs of moderate depression are:

1. Significant disturbances in the functioning of the gastrointestinal tract:

sudden loss of appetite or overeating;
rapid loss (or gain) in weight (up to 10 kg in 7-14 days);
changes in taste preferences;
constipation (diarrhea).

2. Sleep disturbance:

insomnia at night is accompanied by falling asleep for a long time and waking up around 3-4 o'clock in the morning;
drowsy state throughout the day.

3. Changes in the musculoskeletal system:

movements are inhibited;
fussiness;
muscle spasms “grab”;
eyelids twitch;
back and joint pain;
weakness in the limbs.

4. Malfunction of the cardiovascular system:

blood pressure increases;
sharp or aching frequent pain in the heart;
Heartbeats periodically become more frequent.

How to take the test for free

Now there are many offers on how to take the Beck Depression Inventory test online and for free. The big advantage is that you don’t have to spend a lot of time completing it.

The method under consideration is a popular and sought-after way to determine depressive syndrome even in the early stages. It is noteworthy that shortly after its creation, the questionnaire was repeatedly updated and rewritten.

This was done only out of necessity so that the information contained did not contradict international research related to the diagnosis and treatment of mental disorders. The last time the test was changed was in 1996.

If you decide to take the Beck Depression Test online, you will need to check only one option. At the very end, click the “Finish” button to find out the result.

The Beck Depression Inventory necessarily describes the following clinical symptoms of this mental disorder:

pessimistic attitude towards the world;
derogatory state of mind;
factors of dissatisfaction, recognition of personal uselessness, uselessness to anyone in this world;
unreasonable feelings of guilt with expected punishment in the very near future;
destruction of social contacts;
poor sleep, low performance;
lack of appetite, which can lead to anorexia;
loss of libido;
excessive fatigue;
increased irritability, turning into nervous breakdowns;
thoughts about taking his own life.

Such a state depresses a person.
When a person decides to take the Beck Depression Inventory test online, it is useful to know that the questionnaire itself is conditionally divided into two basic groups:

Questions No. 1-13 are formulated in such a way as to indicate to a person probable changes in his behavior, which can occur depending on the surrounding situation, but at the same time in a completely predictable and definite way (we are talking about the cognitive-affective subscale);
The second type is questions No. 14-21. Aimed at determining the somatic or physical manifestations of the disease.

You can take the Beck Depression Inventory online below. Having determined which option fits where, you need to determine how many points you managed to score.

Severe depression causes

The causes are conventionally divided into two groups: psychological, which affect the soul, and physiological, which arise due to a disorder in the production of neurotransmitters.

Psychological causes include stress, various mental traumas: the death of loved ones, the experience of physical violence, presence at disasters. Often this condition disappears after two months, but in the absence of proper help it can drag on and become serious.

Constant stressful situations include minor troubles that last a long time. Such provoking troubles include living in the same territory with an unwanted person who is annoying; doing unloved work; poverty; chronic diseases that reduce quality of life. Old trauma refers to injuries received in childhood that suddenly resurface.

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Frustration is the next cause of severe depression. This state is characterized by a feeling of unfulfilled desire.

The next reason is an existential crisis, which manifests itself in the loss of meaning, goals, and a sense of harmony. It is often both a sign and a cause of severe depression.

Physiological causes include overwork, exhaustion, cerebral circulatory failure, poisoning with alcohol, drugs, and medications; menopause, strokes, traumatic brain injuries, irregular sex life, as well as its absence; hormonal diseases, insufficient physical activity, diseases of internal organs, unhealthy diet, defects of the neurotransmitter system, hypovitaminosis.

Diagnosis of moderate depression

To make a correct diagnosis and prescribe effective treatment, the doctor needs to conduct a number of studies:

personal communication with the patient (to collect information in order to “put together a picture” of the patient’s state of health);
general blood analysis;
blood chemistry;
general urine analysis.

In order to identify the degree of depression yourself, you should use the following method:

1. You must select two of three options for the symptoms of the proposed list:

depressive apathetic state;
interest in the type of activity that was previously interesting to the patient decreases;
Energy decreases sharply and fatigue quickly sets in.

2. Select 3-4 symptomatic criteria for a depressive state at the moment:

self-confidence decreases and self-esteem falls;
self-criticism occurs without obvious grounds and a feeling of guilt manifests itself;
thoughts of suicide arise, which are periodically repeated;
sleep is disturbed;
the level of concentration decreases;
loss of appetite.

3. The depressive state lasts about 14 days.

Critical indicators

A score from thirty to sixty-three points indicates a severe depressive state. Such a diagnosis has characteristic symptoms, which include the following conditions:

depressed state;
insomnia;
emotional disruptions;
sadness;
feelings of inferiority and uselessness;
lack of interest in what is happening around;
rapid fatigue that occurs after any activity;
loss of appetite and weight loss;
pessimism.

It is typical that such patients very often fall into a hysterical situation, sometimes even prone to aggression and violence directed at people around them. They have suicidal thoughts too often, so this condition requires urgent, high-quality treatment.

Severe depression treatment

People faced with a similar problem are interested in the question - what to do with a high degree of depression according to Beck? Do I need to contact a specialist or is it possible to cope with the situation on my own? It should be borne in mind that any test is only indicative material for making a diagnosis.

If a person has restless thoughts, despair and fear that arise too often, then this is a reason to consult a psychotherapist. There is no point in trying to deal with these manifestations on your own, as this can only aggravate an already difficult situation.

A person should take into account that treatment for depression is not always carried out in a hospital setting; it can also be done at home. For this, antidepressants are most often prescribed, and the mild form involves the use of herbal preparations, for example, Hypericin, which is an extract from St. John's wort.

The following medications are more powerful antidepressants:

Fluoxetine and Cipramil, which are stimulant drugs.
Parasidol and Desipramine have a positive effect on the anxiety component of the disease.
Amitriptyline is used for people with suicidal tendencies; it has a sedative effect on pathology.

Coaxil is prescribed for intolerance to antidepressants, but when using it, it should be taken into account that it lowers blood pressure and is often prescribed for this purpose.

In cases of mild to moderate forms of the disease, psychotherapy should be used, which in some situations is combined with psychotropic medications.

Another effective method of combating depression is regular physical exercise, which actively produces the joy hormone. And it doesn’t have to be hour-long workouts in the gym; it can be swimming, yoga, or even just walking. But this method is not effective for severe depression.

Today, many people suffer from psychological oppression, but identifying it is not so easy, especially when there is no opportunity to communicate with loved ones in person. A person continues to feel incompetent and depressed every day, which only worsens his deteriorating state. All this often leads to suicidal thoughts, and only timely diagnosis and treatment can save a person.

Treatment for severe depression includes family and individual counseling. The psychologist's attention will not be ignored by such conditions as difficulties in communication, violation of mutual understanding with parents, spouse, children, loved ones; divorce, experiencing personal crises, death of a loved one, separation from a loved one, fears, loneliness, self-doubt, loss of meaning in life, raising teenagers and children, psychosomatic diseases.

Severe depression symptoms

Symptoms of severe depression: low mood, loss of pleasure and interests, decreased energy, increased fatigue, decreased activity and concentration, low self-esteem and lack of confidence, ideas of self-deprecation and guilt, a pessimistic and gloomy vision of the future; suicidal tendencies, sleep disturbances, loss of appetite.

The main symptoms of severe depression include the patient's daily depressed mood, decreased interest in previous activities, deterioration in the ability to think and concentrate, hesitation and indecisiveness, lethargy, changes in psychomotor activity, and loss of libido.

The clinical characteristics of severe depression are differentiated by the leading affect. Melancholy depression has an affect of melancholy, the experience of a life impasse, hopelessness, lack of perspective, chest sensations of heaviness, deterioration in the morning, psychomotor retardation, and disturbances in night sleep in the second half of the night.

Anxious depression is marked by the expectation of misfortune in the future, feelings of lack of air and anxiety in the chest, mental pain, psychomotor agitation, worsening of the condition in the evening, difficulty falling asleep, as well as worsening of night sleep in the first half of the night.

Apathetic severe depression is manifested by an affect of apathy with a painful feeling of laziness, as well as passivity, inability to exert volition, inactivity, and drowsiness.

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