Depressive Symptoms

The Beck Depression Inventory, version 1 (BDI-1) is a 21-item self-administered survey to assess presence/severity of psychological and physical symptoms of depression over the past week⁽²⁴⁾. It was administered at all assessments except year 6. Questions are assessed on a four-point scale ranging from 0 (symptom not present) to 3 (symptom very intense). The total score ranges from 0-63, with a higher score indicating greater depressive symptomology. Because many patients are advised to lose weight in preparation for surgery, no points were assigned to the BDI item, “I have lost more than 5 pounds,” for participants who indicated purposefully trying to lose weight. Cronbach’s alpha coefficient for the BDI score was 0.87 pre-surgery, and 0.90 1 year post-RYGB. Change in score was calculated as post-surgery score – pre-surgery score; thus, a negative value indicates improvement.