Skip to main content
Top
Published in: Health and Quality of Life Outcomes 1/2005

Open Access 01-12-2005 | Research

Usefulness of five-item and three-item Mental Health Inventories to screen for depressive symptoms in the general population of Japan

Authors: Shin Yamazaki, Shunichi Fukuhara, Joseph Green

Published in: Health and Quality of Life Outcomes | Issue 1/2005

Login to get access

Abstract

Background

The five-question Mental Health Inventory (MHI-5) is a brief questionnaire that can be used to screen for depressive symptoms. Removing the 2 anxiety-related items from the MHI-5 yields the MHI-3. We assessed the performance of the Japanese versions of the MHI-5 and MHI-3 in detecting depressive symptoms in the general population of Japan.

Methods

From the population of Japan, 4500 people 16 years old or older were selected by stratified-random sampling. The Medical Outcomes Study 36-Item Short Form Health Survey (SF-36, which includes the MHI-5) and the Zung Self-rating Depression Scale (ZSDS) were included in a self-administered questionnaire. ZSDS scores of 48 and above were taken to indicate the presence of moderate or severe depressive symptoms, and scores of 56 and above were taken to indicate the presence of severe depressive symptoms. We computed the correlation coefficient between the ZSDS score and the scores on the MHI-5 and MHI-3. We also computed the sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve.

Results

Of the 3107 subjects (69% of the 4500 initially selected), 14.0% had moderate or severe depressive symptoms, and 2.0% had severe depressive symptoms as measured with the ZSDS. The correlations of ZSDS scores with MHI-5 scores and with MHI-3 scores were similar: -0.63 and -0.61, respectively. These correlation coefficients were almost the same whether or not the data were stratified by age and sex. For detecting severe depressive symptoms with the MHI-5, the area under the ROC curve was 0.942 (95%CI: 0.919 – 0.965); for the MHI-3, it was 0.933 (95%CI: 0.904 – 0.962).

Conclusion

The MHI-5 and MHI-3 scores were correlated with the ZSDS score, and can be used to identify people with depressive symptoms in the general population of Japan.
Appendix
Available only for authorised users
Literature
1.
go back to reference Tamakoshi A, Ohno Y, Aoki K, Hamajima N, Wada M, Kawamura T, Wakai K, Lin YS: Depressive mood and suicide among middle-aged workers: findings from a prospective cohort study in Nagoya, Japan. J Epidemiol 2000, 10: 173–178.PubMedCrossRef Tamakoshi A, Ohno Y, Aoki K, Hamajima N, Wada M, Kawamura T, Wakai K, Lin YS: Depressive mood and suicide among middle-aged workers: findings from a prospective cohort study in Nagoya, Japan. J Epidemiol 2000, 10: 173–178.PubMedCrossRef
3.
go back to reference Kawakami N, Shimizu H, Haratani T, Iwata N, Kitamura T: Lifetime and 6-month prevalence of DSM-III-R psychiatric disorders in an urban community in Japan. Psychiatry Res 2004, 121: 293–301. 10.1016/S0165-1781(03)00239-7PubMedCrossRef Kawakami N, Shimizu H, Haratani T, Iwata N, Kitamura T: Lifetime and 6-month prevalence of DSM-III-R psychiatric disorders in an urban community in Japan. Psychiatry Res 2004, 121: 293–301. 10.1016/S0165-1781(03)00239-7PubMedCrossRef
4.
go back to reference The WHO World Mental Health Survey Consortium: Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA 2004, 291: 2581–2590. 10.1001/jama.291.21.2581CrossRef The WHO World Mental Health Survey Consortium: Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA 2004, 291: 2581–2590. 10.1001/jama.291.21.2581CrossRef
5.
go back to reference Whooley MA, Avins AL, Miranda J, Browner WS: Case-finding instruments for depression. Two questions are as good as many. J Gen Intern Med 1997, 12: 439–445. 10.1046/j.1525-1497.1997.00076.xPubMedCentralPubMedCrossRef Whooley MA, Avins AL, Miranda J, Browner WS: Case-finding instruments for depression. Two questions are as good as many. J Gen Intern Med 1997, 12: 439–445. 10.1046/j.1525-1497.1997.00076.xPubMedCentralPubMedCrossRef
6.
go back to reference Berwick DM, Murphy JM, Goldman PA, Ware JE Jr, Barsky AJ, Weinstein MC: Performance of a five-item mental health screening test. Med Care 1991, 29: 169–176.PubMedCrossRef Berwick DM, Murphy JM, Goldman PA, Ware JE Jr, Barsky AJ, Weinstein MC: Performance of a five-item mental health screening test. Med Care 1991, 29: 169–176.PubMedCrossRef
7.
go back to reference Rumpf HJ, Meyer C, Hapke U, John U: Screening for mental health: validity of the MHI-5 using DSM-IV Axis I psychiatric disorders as gold standard. Psychiatry Res 2001, 105: 243–253. 10.1016/S0165-1781(01)00329-8PubMedCrossRef Rumpf HJ, Meyer C, Hapke U, John U: Screening for mental health: validity of the MHI-5 using DSM-IV Axis I psychiatric disorders as gold standard. Psychiatry Res 2001, 105: 243–253. 10.1016/S0165-1781(01)00329-8PubMedCrossRef
8.
go back to reference Fukuhara S, Bito S, Green J, Hsiao A, Kurokawa K: Translation, adaptation, and validation of the SF-36 Health Survey for use in Japan. J Clin Epidemiol 1998, 51: 1037–1044. 10.1016/S0895-4356(98)00095-XPubMedCrossRef Fukuhara S, Bito S, Green J, Hsiao A, Kurokawa K: Translation, adaptation, and validation of the SF-36 Health Survey for use in Japan. J Clin Epidemiol 1998, 51: 1037–1044. 10.1016/S0895-4356(98)00095-XPubMedCrossRef
9.
go back to reference Fukuhara S, Ware JE Jr, Kosinski M, Wada S, Gandek B: Psychometric and clinical tests of validity of the Japanese SF-36 Health Survey. J Clin Epidemiol 1998, 51: 1045–1053. 10.1016/S0895-4356(98)00096-1PubMedCrossRef Fukuhara S, Ware JE Jr, Kosinski M, Wada S, Gandek B: Psychometric and clinical tests of validity of the Japanese SF-36 Health Survey. J Clin Epidemiol 1998, 51: 1045–1053. 10.1016/S0895-4356(98)00096-1PubMedCrossRef
10.
12.
go back to reference Biggs JT, Wylie LT, Ziegler VE: Validity of the Zung Self-rating Depression Scale. Br J Psychiatry 1978, 32: 381–385.CrossRef Biggs JT, Wylie LT, Ziegler VE: Validity of the Zung Self-rating Depression Scale. Br J Psychiatry 1978, 32: 381–385.CrossRef
13.
go back to reference Gabrys JB, Peters K: Reliability, discriminant and predictive validity of the Zung Self-rating Depression Scale. Psycholog Reports 1985, 57: 1091–1096.CrossRef Gabrys JB, Peters K: Reliability, discriminant and predictive validity of the Zung Self-rating Depression Scale. Psycholog Reports 1985, 57: 1091–1096.CrossRef
14.
go back to reference Agrell B, Dehlin O: Comparison of six depressive rating scales in geriatric stroke patients. Stroke 1989, 20: 1990–1994.CrossRef Agrell B, Dehlin O: Comparison of six depressive rating scales in geriatric stroke patients. Stroke 1989, 20: 1990–1994.CrossRef
16.
go back to reference Barrett J, Hurst MW, DiScala C, Rose RM: Prevalence of depression over a 12-month period in a nonpatient population. Arch Gen Psychiatry 1978, 35: 741–744.PubMedCrossRef Barrett J, Hurst MW, DiScala C, Rose RM: Prevalence of depression over a 12-month period in a nonpatient population. Arch Gen Psychiatry 1978, 35: 741–744.PubMedCrossRef
17.
go back to reference Fukuda K, Kobayashi S: A study on a self-rating depression scale. Seishin Shinkeigaku Zasshi 1973, 75: 673–679. (in Japanese)PubMed Fukuda K, Kobayashi S: A study on a self-rating depression scale. Seishin Shinkeigaku Zasshi 1973, 75: 673–679. (in Japanese)PubMed
18.
go back to reference Ware JE, Snow KK, Kosinski M, Gandek B: SF-36 health survey manual & interpretation guide. Boston, New England Medical Center; 1993. Ware JE, Snow KK, Kosinski M, Gandek B: SF-36 health survey manual & interpretation guide. Boston, New England Medical Center; 1993.
20.
go back to reference Swets JA, Pickett RM, Whitehead SF, Getty DJ, Schnur JA, Swets JB, Freeman BA: Assessment of diagnostic technologies. Science 1979, 205: 753–759.PubMedCrossRef Swets JA, Pickett RM, Whitehead SF, Getty DJ, Schnur JA, Swets JB, Freeman BA: Assessment of diagnostic technologies. Science 1979, 205: 753–759.PubMedCrossRef
21.
go back to reference Hanley JA, McNeil BJ: The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology 1982, 143: 29–36.PubMedCrossRef Hanley JA, McNeil BJ: The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology 1982, 143: 29–36.PubMedCrossRef
22.
go back to reference Hanley JA, McNeil BJ: A method of comparing the areas under receiver operating characteristic curves derived from the same cases. Radiology 1983, 148: 839–843.PubMedCrossRef Hanley JA, McNeil BJ: A method of comparing the areas under receiver operating characteristic curves derived from the same cases. Radiology 1983, 148: 839–843.PubMedCrossRef
23.
go back to reference Kawakami N, Takatsuka N, Shimizu H, Ishibashi H: Depressive symptoms and occurrence of type 2 diabetes among Japanese men. Diabetes Care 1999, 22: 1071–6.PubMedCrossRef Kawakami N, Takatsuka N, Shimizu H, Ishibashi H: Depressive symptoms and occurrence of type 2 diabetes among Japanese men. Diabetes Care 1999, 22: 1071–6.PubMedCrossRef
Metadata
Title
Usefulness of five-item and three-item Mental Health Inventories to screen for depressive symptoms in the general population of Japan
Authors
Shin Yamazaki
Shunichi Fukuhara
Joseph Green
Publication date
01-12-2005
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2005
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-3-48

Other articles of this Issue 1/2005

Health and Quality of Life Outcomes 1/2005 Go to the issue