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