Application of the stratum-specific likelihood ratio (SSLR) analysis to results of a depressive symptoms screening survey among Japanese workers

Background The stratum-specific likelihood ratio (SSLR) has been widely used as a convenient method to interpret the results of screening surveys. In the present paper, an SSLR analysis is applied to the results of a survey that used the Center for Epidemiologic Studies Depression Scale (CES-D) to identify depressive symptoms in a group of Japanese workers in an attempt to determine score categories that have predictive clinical values in a screening context. Methods The self-reported CES-D and the Mini International Neuropsychiatric Interview (MINI) were administered to 2,219 workers (84.2% men; age 21–68 years) during a periodical medical examination. The SSLR was calculated to determine strata with optimal discrimination for major depressive disorder (MDD). Results For MDD, the SSLR was 0.06 (95%CI: 0.02–0.18) for the CES-D score range 0–16, 1.90 (0.78–4.62) for the score range 17–19, and 12.4 (10.2–15.1) for the score above 20. Conclusions The SSLR shown in this study proposes score categories that guide clinicians in selecting the workers most at risks of having MDD among Japanese workers.