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International Journal of Methods in Psychiatric Research logoLink to International Journal of Methods in Psychiatric Research
. 2010 Nov 25;19(4):211–222. doi: 10.1002/mpr.320

Evaluation of the DSM‐IV and ICD‐10 criteria for depressive disorders in a community population in Japan using item response theory

Mari Saito 1,✉, Noboru Iwata 2, Norito Kawakami 3, Yutaka Matsuyama 4, Yutaka Ono 5, Yoshibumi Nakane 6, Yoshikazu Nakamura 7, Hisateru Tachimori 8, Hidenori Uda 9, Hideyuki Nakane 10, Makoto Watanabe 7, Yoichi Naganuma 8, Toshiaki A Furukawa 11, Yukihiro Hata 12, Masayo Kobayashi 7, Yuko Miyake 8, Tadashi Takeshima 8, Takehiko Kikkawa 13
PMCID: PMC3671887  NIHMSID: NIHMS409599  PMID: 20645305

Abstract

The DSM‐IV and ICD‐10 are both operational diagnostic systems that classify known psychological disorders according to the number of criteria symptoms. Certain discrepancies between the criteria exist and may lead to some inconsistencies in psychiatric research. The purpose of this study was to investigate these differences in the assessment of depression with item response theory (IRT) analyses. The World Mental Health‐Japan (WMHJ) Survey is an epidemiological survey of the general population in Japan. We analyzed data from the WMHJ completed by 353 respondents who had either depressive mood or diminished interest. A two‐parameter logistic model was used to evaluate the characteristics of the symptoms of the DSM‐IV and ICD‐10. IRT analyses revealed that the symptoms about psychomotor activity, worthlessness and self‐reproach were more informative and suggestive of greater severity, while the symptoms about dietary habits were less informative. IRT analyses also revealed that the ICD‐10 seems more sensitive to the mild range of the depression spectrum compared to the DSM‐IV. Although there were some variations in severity among respondents, most of the respondents diagnosed with a severe or moderate depressive episode according to the ICD‐10 were also diagnosed with a major depressive episode according to the DSM‐IV.

Keywords: depression, World Mental Health Japan Survey, DSM‐IV, ICD‐10, item response theory

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Acknowledgements

The World Mental Health Japan (WMHJ) set of surveys is supported by a Grant for Research on Psychiatric and Neurological Diseases and Mental Health (H13‐SHOGAI‐023, H14‐TOKUBETSU‐026, H16‐KOKORO‐013, H19‐KOKORO‐IPPAN‐011) from the Japan Ministry of Health, Labor, and Welfare. We thank the staff members, filed coordinators, and interviewers of the WMHJ 2002–2004 Survey. The WMHJ 2002–2004 Survey was carried out in conjunction with the World Health Organization (WHO) World Mental Health (WMH) Survey Initiative. We also thank the WMH staff for assistance with instrumentation and fieldwork. These activities were supported by the US National Institute of Mental Health (R01MH070884), the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, the US Public Health Service (R13‐MH066849, R01‐MH069864, and R01 DA016558), the Fogarty International Center (FIRCA R01‐TW006481), the Pan American Health Organization, Eli Lilly and Company, Ortho‐McNeil Pharmaceutical, Inc., GlaxoSmithKline, and Bristol‐Myers Squibb. A complete list of WMH publications can be found at http://www.hcp.med.harvard.edu/wmh/

Appendix 1

Details of the 14 symptoms used to evaluate depression in the WHO‐CIDI 3.0.

Q1  Depressed mood

Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g. feels sad or empty) or observations made by others.

Q2  Loss of interest (anhendonia)

Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others).

Q3  Weight or appetite changes

Significant weight loss when not dieting or weight gain (e.g. change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day.

Q4  Sleep problems

Insomnia or hypersomnia nearly every day (sleep disturbance of any type).

Q5  Objective psychomotor activities

Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).

Q6  Fatigability

Fatigability or loss of energy nearly every day.

Q7  Worthlessness

Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self‐reproach or guilt about being sick).

Q8  Concentration difficulty

Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others). Complaints or evidence of diminished ability to think or concentrate, such as indecisiveness or vacillation.

Q9  Suicidal ideation

Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

Q10 Loss of confidence

Loss of confidence or self‐esteem.

Q11 Self‐reproach

Unreasonable feelings of self‐reproach or excessive and inappropriate guilt.

Q12 Psychomotor symptom (objective or subjective)

Change in psychomotor activity, with agitation or retardation either objectively observed by others or subjectively‐assessed

Q13 Weight and appetite changes

Change in appetite (decrease or increase) with corresponding weight change.

Q14 Non‐reactive depressed mood

Depressed mood to a degree that is definitely abnormal for the individual, present for most of the day and almost every day, largely uninfluenced by circumstances, and sustained for at least two weeks.

Appendix 2

Formula used to calculate fit statistics

The value Oij is an observed response of respondent i to item j, Eij is the expected value, and σj 2 is the variance of expectation. The squared standardized residual of respondent i to item j is then expressed as follows:

equation image

The outfit statistic is the mean of the squared standardized residuals in the respondents. The infit statistic is the information‐weighted (i.e. inverse of variance‐weighted) mean of the standardized residuals.

equation image
equation image

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