Abstract
BackgroundThe 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.MethodsFrom 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.ResultsOf 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).ConclusionThe 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.
Highlights
The five-question Mental Health Inventory (MHI-5) is a brief questionnaire that can be used to screen for depressive symptoms
The MHI-5 is used as the "Mental Health" domain of the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36)
The SF-36 has been translated into Japanese [8], and the Japanese version has been validated for use in the general population of Japan [9], but the performance of the MHI-5 has not been evaluated in detail
Summary
The five-question Mental Health Inventory (MHI-5) is a brief questionnaire that can be used to screen for depressive symptoms. To assist in detecting depression or depressive symptoms, many screening questionnaires have been developed Some of these have 20 to 30 items, take only a few minutes to complete, use the number of symptoms as the score, and have good performance to detect depressive state. Instruments that are even shorter but have good performance to detect depressive state have been developed [5,6,7] One such questionnaire is the five-item version of the Mental Health Inventory (MHI-5) [6,7]. We hypothesized that removing those two anxiety-related items would result in a scale (the MHI-3) that performs as well as the MHI-5 in detecting symptoms of depression
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