The Burns Depression Checklist (BDC) measures depression severity by adding the scores of 25 symptom items. However, the total score does not show which items contribute most to the severity category. This study presents an interpretable machine learning pipeline to rank predictive BDC items. We analyzed responses from 654 university students in Bangladesh. We first examined the reliability and relationships of the BDC items. We then tested seven machine learning classifiers. We also applied four feature selection methods—RFE, SKB, UFS, and MIFS—and two explanation methods, SHAP and LIME. The BDC showed strong internal consistency, with a Cronbach’s alpha of 0.91. The full-item stacking model achieved 90.84% test accuracy, 86.03% balanced accuracy, and 82.60% macro-F1. We combined the six item rankings on one common scale. Loss of motivation received the highest rank. Loss of interest in work, loneliness, discouragement, hopelessness, and reduced social interest also ranked highly. These items represent reduced motivation, social withdrawal, negative mood, and negative self-view. The main contribution of this study is an item-level ranking that combines evidence from several analytical methods. However, the target categories come directly from the same 25 BDC items. Therefore, the results show how well the models reconstruct BDC severity categories, not how well they diagnose clinical depression. The rankings also do not show clinical urgency. Any positive response to a suicide related item requires separate professional assessment.
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