Validation of the Beck Depression Inventory in US Hispanic Patients with CKD.

Key Points: The Beck Depression Inventory is a valid instrument to screen for depressive symptoms in Hispanic adults with CKD. Using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Disorders as the gold standard, a Beck Depression Inventory of ≥16 was found to be the optimal screening cutoff in Hispanic adults with nondialysis CKD or ESKD.

Background: Depression is common in patients with CKD. Self-report scales, including the Beck Depression Inventory (BDI), have been evaluated in non-Hispanic adults with CKD for screening of depressive symptoms. However, the BDI has not been validated in Hispanic adults with CKD.

Methods: We investigated the screening characteristics of the BDI in 248 Hispanic adults (164 with CKD and 84 with ESKD) enrolled in the Hispanic Chronic Renal Insufficiency Cohort Study. Two trained study personnel administered the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Disorders, which served as the gold-standard measure for the diagnosis of major depression.

Results: Among the 164 participants with CKD, the mean (SD) age was 61 (0.8) years, 37% were female, 77% spoke primarily Spanish, mean (SD) eGFR was 37 (1.3) ml/min per 1.73 m, and median (interquartile range) proteinuria was 0.4 (0.1–2.0) g/g. Using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Disorders, 24 (15%) were classified as having current major depressive disorder. The best cutoff BDI score to identify current major depression disorder on the basis of the receiver-operating characteristic curve was 16. Sensitivity was 88%, specificity was 84%, positive predictive value was 49%, and negative predictive value was 98%. Similar results were found in participants with ESKD.

Conclusions: A BDI score of ≥16 was sensitive and specific for identifying major depression in US Hispanic adults with CKD and ESKD, which is a higher cutoff than reported for non-Hispanic patients with CKD. These differences in psychometric properties should be considered in future research and clinical practice.