Interactive Interpreter

BDI-II Scoring Guide · Beck Depression Inventory

The BDI-II (Beck Depression Inventory, Second Edition) is a 21-item self-report questionnaire that measures the severity of depressive symptoms over the past two weeks. Scores range 0–63 across four bands (minimal, mild, moderate, severe), and it is widely used in CBT research and clinical settings.

For professional reference, research, and education only. Not for diagnosis or medical advice.

BDI-II Score Interpreter

  • BDI-II Score Calculator

    Enter each of the 21 items (0–3) to total them and see the band. Items are numbered, not reproduced: enter them from the licensed form in front of you. Scoring aid only; it does not diagnose.

    0 of 21 items entered — 21 still blank. The total can only rise, so treat the range as provisional.

    Item 1
    Item 2
    Item 3
    Item 4
    Item 5
    Item 6
    Item 7
    Item 8
    Item 9
    Item 10
    Item 11
    Item 12
    Item 13
    Item 14
    Item 15
    Item 16
    Item 17
    Item 18
    Item 19
    Item 20
    Item 21

    Each item scores 0–3. Response anchors differ by item on this scale, so use the wording printed on the form.

  • Enter a total score to see its range.

  • 21 items rated 0–3; sum all items for a total of 0–63. The BDI-II is © Pearson and administration requires purchase from Pearson — this interpreter classifies an already-calculated score. Always review Item 9 (suicidal thoughts) independently; any score above 0 requires immediate follow-up.

    Total scoreInterpretation
    29+SevereScore 29–63. Severe depressive symptoms; immediate clinical assessment recommended, including suicidality screening (Item 9) and crisis protocol.
    20–28ModerateScore 20–28. Moderate depressive symptoms; active clinical follow-up indicated.
    14–19MildScore 14–19. Mild depressive symptoms above the minimal range.
    0–13MinimalScore 0–13. Minimal depressive symptoms within the normal range.

    Beck et al. (1996). Severity bands per the BDI-II manual (Pearson).

The Beck Depression Inventory-II (BDI-II) is a 21-item self-report questionnaire that measures the severity of depressive symptoms over the past two weeks. Totals run from 0 to 63, and it is used for screening, treatment monitoring and research.

What does the BDI-II measure?

The BDI-II is one of the most widely used scales for measuring the severity of depression. Aaron T. Beck and colleagues published it in 1996 as a revision of the original BDI [1].

It was aligned with the DSM-IV criteria for major depressive disorder.

The 21 items each correspond to a symptom of depression, such as sadness, pessimism, loss of interest, fatigue, sleep disturbance and suicidal thoughts. Respondents rate each item from 0 to 3 based on how they have felt over the past two weeks.

The total runs from 0 to 63; higher scores mean more severe depression. A review of 118 studies covered non-clinical, psychiatric and medical samples [2].

Clinical use only

The BDI-II measures symptom severity. A diagnosis of depression needs a full clinical evaluation by a qualified mental health professional; the BDI-II helps identify symptoms but does not replace clinical judgment.

How do you give the BDI-II?

  • Self-report. Clients complete the 21 items on their own, in the waiting room or by secure link before an appointment.
  • Time. It typically takes 5 to 10 minutes. Scoring is the sum of all 21 items.
  • Timeframe. Instructions ask respondents to consider the past two weeks, including the day of administration.
  • Regular monitoring. Give it at intake, at regular intervals during treatment and at discharge, so changes can be tracked.

Administration best practices

  • Make sure the client understands the 0 to 3 rating before starting
  • Review item 9 (suicidal thoughts) promptly; do not delay follow-up
  • Use the same version (paper or digital) for longitudinal tracking
  • Combine with the PHQ-9 or GAD-7 for a broader symptom picture

How do you score and interpret the BDI-II?

Totals run from 0 to 63: 0–13 minimal, 14–19 mild, 20–28 moderate and 29–63 severe, the ranges set in the BDI-II manual. The scorer at the top of this page shows each range with its note.

The best cutoff for screening varies with the type of sample, so a single threshold does not fit every setting [2].

Suicidality screening (item 9)

Item 9 assesses suicidal thoughts and intentions. Any score above 0 on this item requires immediate clinical follow-up:

  • Ratings run from 0 to 3; higher ratings reflect more severe suicidal thoughts or wishes
  • A rating on item 9 is not a risk assessment; it signals the need for one

Always conduct a safety assessment when item 9 is above 0.

Monitoring treatment response

In data from three randomized trials (1,039 participants), the minimal clinically important difference was a 17.5% reduction from baseline, as judged by participants who reported feeling better. For longer-lasting depression that had not responded to antidepressants it was higher, at 32% [3].

The authors found that meaningful change depends on baseline severity and is best read as a percentage drop, not a fixed number of points [3]. Track scores over time to show progress and spot non-responders early.

Psychometric properties

  • Comparison study. The BDI-II was self-administered to 140 psychiatric outpatients with various psychiatric disorders and showed a coefficient alpha of .91 [1].
  • Versus the BDI-IA. Mean BDI-II totals were about 2 points higher than on the earlier BDI-IA, and outpatients endorsed about one more symptom [1]. This is one reason the two versions should not be mixed in longitudinal tracking.
  • Review of 118 studies. Internal consistency was around 0.9 and retest reliability ranged from 0.73 to 0.96. Factor analysis showed a general depression dimension made up of cognitive-affective and somatic-vegetative parts [2].

Limitations

  • Not diagnostic. The BDI-II measures symptom severity; a diagnosis of major depressive disorder requires a full clinical evaluation.
  • Self-report. Scores depend on the respondent's insight, reading level and willingness to disclose symptoms.
  • Somatic items. Items such as fatigue, sleep and appetite change can be elevated by medical illness, pregnancy or medication effects.
  • Item 9 needs separate review. The total score can be low while item 9 is endorsed, so suicidal thoughts must be followed up independently of the severity band.
  • Cutoffs vary by sample. The best screening cutoff differs between non-clinical, psychiatric and medical groups [2].

How does the BDI-II compare with other depression scales?

Each depression scale suits a different setting.

BDI-II vs PHQ-9: detailed vs brief screening

The PHQ-9 suits busy primary care and integrated care, where rapid screening matters and cost is a factor. Its items follow the DSM criteria for major depression, which makes documentation straightforward.

Choose the BDI-II for detailed symptom profiling in specialized mental health settings or outcome research, where the licence cost is not a barrier. Both can monitor treatment response over time.

BDI-II vs HAM-D: self-report vs clinician-rated

The BDI-II captures the client's own experience of depression, while the HAM-D relies on a clinician's interview and observation. Research often uses both, to capture subjective and observed perspectives.

In routine practice the BDI-II needs no clinician time to complete. The HAM-D is used where standardized clinician ratings are needed, as in many medication trials.

Some clinics pair them: the BDI-II for frequent self-monitoring and the HAM-D for periodic full evaluations.

BDI-II vs the original BDI

Use the BDI-II rather than the original BDI. The BDI-II was revised to match the DSM-IV criteria and uses a two-week timeframe [1]. The original BDI is mainly useful for comparison with historical data.

If a study cites "BDI" without a version, check which edition it used.

Do not mix BDI and BDI-II scores in longitudinal tracking: they are not interchangeable [1]. If switching versions, note the change in the record and interpret trends with caution.

Documenting BDI-II scores

BDI-II scores belong in the Objective section of a note. See the SOAP notes guide for templates and examples.

For individuals: This page is a clinical reference, not a diagnostic tool. If you have concerns about your own symptoms, bring this information to a qualified mental health professional.

Related

FAQ

  • What is the BDI-II?

    The BDI-II (Beck Depression Inventory, Second Edition) is a 21-item self-report depression severity scale aligned with DSM-IV and DSM-5-TR criteria, scoring 0 to 63. Each item asks how the respondent has felt over the past two weeks, rated 0 to 3. Developed by Aaron T. Beck (1996) as a revision of the original BDI.

  • How do you score the BDI-II?

    Respondents rate each of 21 depression symptoms on a 4-point scale (0 to 3) based on how they have felt over the past two weeks. Item scores are summed for a total ranging from 0 to 63. Severity bands are 0 to 13 minimal, 14 to 19 mild, 20 to 28 moderate, and 29 to 63 severe depression.

  • What BDI-II score indicates severe depression?

    A BDI-II score of 29 or higher indicates severe depression. Scores of 20 to 28 indicate moderate depression, 14 to 19 mild, and 0 to 13 minimal depression. Item 9 (suicidal thoughts) requires immediate clinical follow-up regardless of total score if rated above 0.

  • Is the BDI-II free?

    No. The BDI-II is © Pearson and is not in the public domain. Administration requires purchase from Pearson, and use in a third-party digital product requires a commercial licence from Pearson. The PHQ-9 and PHQ-2 are widely used validated alternatives that align with DSM-5-TR criteria; they are free to use, and Pfizer states no permission is required to reproduce, translate, display or distribute them.

References

    1. 1.Beck AT, Steer RA, Ball R, Ranieri W. Comparison of Beck Depression Inventories -IA and -II in psychiatric outpatients. J Pers Assess. 1996;67(3):588-597.
    2. 2.Wang YP, Gorenstein C. Psychometric properties of the Beck Depression Inventory-II: a comprehensive review. Braz J Psychiatry. 2013;35(4):416-31.
    3. 3.Button KS, Kounali D, Thomas L, et al. Minimal clinically important difference on the Beck Depression Inventory--II according to the patient's perspective. Psychol Med. 2015;45(15):3269-79.

    The BDI-II is © Pearson. Administration requires purchase from Pearson, and use in a third-party digital product requires a commercial licence from Pearson.

This library is an academic and clinical reference. A scale described here is not necessarily offered in HiBoop; each page says whether it is.

Add to your practice