Presentation Information
[O-16-02]Screening for Major Depressive Disorder with the Patient Health Questionnaire-9 (PHQ-9) by Primary Care-Type Physicians in Japan
*Ariel Kiyomi Daoud (University of Cincinnati(United States of America))
Keywords:
Japan,Major Depressive Disorder,Primary Care,Mental Health Screening
This project reviews available English-language literature to examine the process of translation, adaptation, and validation of a Japanese version of the Patient Health Questionnaire-9 (PHQ-9) as a screening tool for Major Depressive Disorder (MDD) in primary care-type settings. A structured literature search was conducted across multiple databases to identify studies evaluating a Japanese version of the PHQ-9. Abstracts were screened for relevance, and nine articles were selected for full-text review. The process used for the Japanese PHQ-9 (J-PHQ-9) was extracted from these studies and compared against a standardized framework for cross-cultural adaptation of health measures. Among the nine reviewed studies, eight utilized a common Japanese version of the PHQ-9, while one study employed an independent version. All studies reported that the J-PHQ-9 is a valid and clinically useful tool. The development of the J-PHQ-9 did not fully adhere to the recommended protocol for cross-cultural validation. However, psychometric analyses consistently demonstrated its reliability and validity in selected samples of the Japanese population. In Japan, preventive care centers on annual health checks by general internal or family medicine physicians, yet depression screening is not routinely included. MDD prevalence estimates range from 1.9%-7.3%, with increasing incidence. Depression-related absenteeism costs the Japanese economy an estimated $6 billion annually, while diagnosis and treatment reduce healthcare costs. Despite this, mental health services are underutilized. Patients often first present to a generalist physician. It is critical that these doctors have and use effective tools for screening. The J-PHQ-9 appears to be appropriate, though key questions emerge from this review: Should depression screening be included in annual exams? Do generalist physicians in Japan feel confident diagnosing and assessing the severity of MDD? Should screening be performed for disorders in Japan with depressive overlap such as modern type depression or hikikomori?