Use of the Beck Depression Inventory for assessing depression in patients hospitalized with severe burn Disentangling symptoms of depression from injury and treatment factors

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Abstract:

The objective of this study was to assess whether scores on the Beck Depression Inventory
(BDI) are biased by injury severity among hospitalized survivors of burn (N = 262). A confirmatory
factor analysis (CFA) model was developed with a general depression factor that
loaded on all items and somatic and cognitive factors that were orthogonal to the general
factor and to each other. The model fit the data well and substantially better than an
alternative three-factor model with correlated factors. Percent total body surface area
burned (TBSA) was significantly associated with the general depression factor ( p = .04),
but also with the orthogonal somatic factor ( p to overlap between somatic symptoms of depression and the severity of the burn injury.
Analysis of item communalities, however, suggested that only approximately 2% of total
predicted item variance was associated with bias related to injury severity. It was concluded
that, despite a small amount of bias, the BDI is a reasonably accurate clinical tool even in the
context of severe burn. Appropriate adjustments for bias, however, should be made in
research with the BDI among patients with acute burn.

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