Application of a stratum-specific likelihood ratio analysis in a screen for depression among a community-dwelling population in Japan

Norio Sugawara,^1,2 Ayako Kaneda,² Ippei Takahashi,³ Shigeyuki Nakaji,³ Norio Yasui-Furukori<sup>2

1</sup>Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, ²Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki, ³Department of Social Medicine, Hirosaki University School of Medicine, Hirosaki, Japan

Background: Efficient screening for depression is important in community mental health. In this study, we applied a stratum-specific likelihood ratio (SSLR) analysis, which is independent of the prevalence of the target disease, to screen for depression among community-dwelling individuals.
Method: The Center for Epidemiologic Studies Depression Scale (CES-D) and the Mini International Neuropsychiatric Interview (MINI) were administered to 789 individuals (19–87 years of age) who participated in the Iwaki Health Promotion Project 2011. Major depressive disorder (MDD) was assessed using the MINI.
Results: For MDD, the SSLRs were 0.13 (95% CI 0.04–0.40), 3.68 (95% CI 1.37–9.89), and 24.77 (95% CI 14.97–40.98) for CES–D scores of 0–16, 17–20, and above 21, respectively.
Conclusion: The validity of the CES-D is confirmed, and SSLR analysis is recommended for its practical value for the detection of individuals with the risk of MDD in the Japanese community.

Keywords: screening, depression, Center for Epidemiologic Studies Depression Scale, stratum-specific likelihood ratio

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