Abstract:
Background: Rates of depression are high among individuals living with HIV. Accurate
assessment of depressive symptoms among this population is important for ensuring proper
diagnosis and treatment. The Beck Depression Inventory-II (BDI-II) is a widely used measure
for assessing depression; however its psychometric properties have not been investigated for
use among HIV-positive populations in Ethiopia.
Objective: To assess the psychometric properties of beck depression inventory II in the
detection of depression among HIV patients in JUMC Jimma, Ethiopia, 2018.
Methods: Institution based cross sectional study was conducted in JUMC ART clinic in a
sample of 152 clients using consecutive sampling method. Cronbach' alpha coefficient was
used to evaluate internal consistency. Semantic validity (Amharic version), Criterion
validity and Convergent validity were analyzed. Sensitivity, specificity, PPV, NPV and
the area under the curve (AUC) for various BDI-II scores was calculated by ROC analysis.
To identify the best fit model PCA was compute for variables which have significant
(p<0.05) and inter-item correlation (r=0.3-0.9).
Results: A total of 152 HIV positive patients participated in the study with 100% response
rate. Using mini international neuropsychiatric interview (MINI) as ‘gold standard’ to
determined major depressive disorder, Sensitivity of 86%, specificity of 83%, PPV (0.82) and
NPV (0.87) were optimal at a cut-off score of 13. Receiver Operating Characteristic (ROC)
analysis confirmed that BDI-II has an adequate diagnostic measure (AUC = 0.90). BDI-II
was good correlation with other construct of WHODAS-12 (r=0.66). Exploratory Factor
analysis revealed three factors that explained 64% of total variance. The BDI-II test scores
showed excellent internal consistency. Cronbach's alpha was 0.91 for the total questionnaire
and 0.91, 0.75 and 0.63 for the three factors respectively. The affective-vegetative, cognitive
and somatic dimensions described the latent structure of the instrument
Conclusions and recommendation: The results suggested that BDI-II is a valid measure for
assessing depressive disorder among HIV-positive patients. Cut-off score was adjusted to
enhance sensitivity and specificity of the tool. A score of 13 and above is appropriate to
screen depression in HIV positive patients
