psychometric properties of beck depression inventory ii screening tool among hiv positive patients in jumc, art clinic, jimma, Ethiopia, 2018

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