Japan-U.S. comparison of responses to depression scale items among adult workers.

The operating characteristics of the Center for Epidemiologic Studies Depression Scale were compared between Japanese and U.S. adult workers. Data were analyzed from age- and education-matched male white collar workers (n = 368 for each) selected from 2016 workers in Japan and 3059 in the United States. The U.S. data were obtained from the 1974-75 Augmentation Survey of the National Health and Examination Survey I. The Japanese responses to positively worded items markedly differed from those of U.S. workers, whereas responses to negatively worded items were generally comparable in the two groups. Thus, spuriously higher positive subscale and whole scale scores were found among the Japanese workers compared with U.S. workers (mean scores: 6.03 vs. 1.83 for the positive subscale and 9.94 vs. 5.35 for the whole scale, respectively; both differences were statistically significant). Negative subscale scores did not differ significantly in the two samples (3.91 vs. 3.52). The present study confirmed the hypothesis of Iwata et al. that Japanese respondents have a tendency to suppress the expression of positive affect.