Cited by 496Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychometric Methodologies and TestingPsychological Testing and Assessment

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Cross-cultural validation of the Beck Depression Inventory-II in Japan

Kojima, Masayo, Furukawa, Toshiaki A, Takahashi, Hidekatsu, Kawai, Makoto, Nagaya, Teruo, Tokudome, Shinkan·2002·Psychiatry Research

DOI 10.1016/s0165-1781(02)00106-3

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Abstract

The Beck Depression Inventory has undergone substantial revision recently as the BDI-II to correspond to DSM-IV criteria. We developed the Japanese version of the BDI-II and examined its psychometric properties. The linguistic equivalence was verified by a back-translation method. The final translation was administered to the visitors at a public health care center, and the responses of 766 adults (age = 24-82 years, women = 40%) were analyzed. Half of the participants completed the Center for Epidemiologic Studies Depression Scale (CES-D) as well. A high level of internal consistency reliability (Cronbach's alpha = 0.87) and item homogeneity was confirmed. Exploratory factor analysis showed a two-factor structure (cognitive and somatic-affective), which was almost identical to the original model demonstrated by Beck et al. (1996, Manual for the Beck Depression Inventor Psychological Corporation, San Antonio, TX, USA). The following confirmatory factor analysis also supported the two-factor structure. Adequate correlation (r = 0.69, P < 0.001) between the total score of the BDI-II and that of the CES-D was observed. A higher score for women compared to men, without significant age differences, was consistent with the results of previous reports. We conclude that the Japanese version of the BDI-II is psychometrically robust and can be used to assess depressive symptoms in Japanese people.

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Uchida, H., Igusa, T., Higashi, Y., Takeda, M., Tsuchiya, K., Kikuchi, S., & Hirao, K. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14020500 · Cited by 3
“BDI-II is one of the most widely used PROs for detecting possible depression in healthy populations and assessing the severity of depressive symptoms in diagnosed patients [31–36].”
Influential
Methylation of the Glucocorticoid Receptor Gene in Children with Somatic Symptom Disorder: A Case-Control Study
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“The Japanese version has shown good test–retest reliability and internal consistency (Cronbach’s α = 0.87) [19].”
Influential
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Ishikawa, R. (2014) · Journal of Depression & Anxiety · doi:10.4172/2167-1044.1000166 · Cited by 3
“Depression:The Beck Depression Inventory version 2 (BDI–II) [24] is a 21–item self–report measure designed to assess symptoms of major depression.”
Method
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Arnault, D. S., Hatashita, H., & Suzuki, H. (2016) · Canadian Journal of Nursing Research · doi:10.1177/0844562116679756 · Cited by 3
“…studies (which were probably translated at the content equivalence level) (Butucescu et al., 2013; De Silva, Ekanayake, & Hanwella, 2014; Kojima et al., 2002; Malakouti, Pachana, Naji, Kahani, & Saeedkhani, 2015; Mazlan & Ahmad, 2013; Tapia, Wagner, Heredia, & GonzálezForteza, 2015;…”
Background
Relationship between the physician-based clinical scale for foot and ankle surgery and patient-reported outcomes in patients with long-standing rheumatoid arthritis: Results from a multicenter prospective observational cohort study
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“Beck Depression Inventory-II (BDI-II) The BDI-II is a 21-item self-administered questionnaire that measures the severity of depressive symptoms.(44) Table 1 Assessment Schedule”
Method
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Okamoto, Y., Takanashi, R., Sutoh, C., Domon, Y., Yamada, M., Baba, Y., Aya, C., Yamanouchi, N., Sasaki, H., & Shimizu, E. (2022) · Medicine · doi:10.1097/md.0000000000028845 · Cited by 3
“The Japanese version of the BDI-II,([20]) a self-administered questionnaire that assesses the severity of depressive symptoms, was used in this study.([21,22]) This scale comprises of 21 items that are rated on a scale of 0–3.”
Method
Feasibility, acceptability, and preliminary efficacy of cognitive processing therapy in Japanese patients with posttraumatic stress disorder
Takagishi, Y., Ito, M., Kanie, A., Morita, N., Makino, M., Katayanagi, A., Sato, T., Imamura, F., Nakajima, S., Oe, Y., et al. (2022) · Journal of Traumatic Stress · doi:10.1002/jts.22901 · Cited by 3
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“Depression severity was assessed using the Japanese version [29] of the BDI-II [30], a self-administered questionnaire that evaluates depression severity over the past two weeks.”
Method
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Kawanishi, H., Hori, H., Yoshida, F., Itoh, M., Lin, M., Niwa, M., Narita, M., Otsuka, T., Ino, K., Imai, R., et al. (2023) · Brain Behavior & Immunity - Health · doi:10.1016/j.bbih.2023.100650 · Cited by 3
“, 1996) We used the validated Japanese version (Kojima et al., 2002) of BDI-II, a 21-item self-report measure of depressive symptoms during the past 2 weeks, in order to assess suicidal ideation in patients and controls.”
Method
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Kalibatseva, Z., Wu, I. H. C., & Leong, F. T. L. (2014) · Springer eBooks · doi:10.1007/978-1-4939-0796-0_12 · Cited by 3
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“This confirms Rachman’s (2006) finding that when one feels responsible or ashamed for participating in a situation that is deemed immoral, one is more likely to experience emotionally charged feelings of dirtiness.”
BackgroundMethodResultInfluential
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Fusegi, K., Hattori, N., Mizuno, Y., & Mori, H. (2012) · Parkinsonism & Related Disorders · doi:10.1016/j.parkreldis.2012.05.006 · Cited by 3
An Example of Psychometric Validation of a Mental Health Questionnaire Used at a Work Place
Kojima, M., Senda, Y., Hayashi, H., & Tokudome, S. (2002) · SANGYO EISEIGAKU ZASSHI · doi:10.1539/sangyoeisei.kj00001039886 · Cited by 3
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Öngel, K., Mergen, H., Tan, S. K., Kişioğlu, A. N., Rc, E., Rc, D., Arslan, B., GÜRBÜZ, T., & Gumral, N. (2010) · Bursa Uludag University - AVESIS · Cited by 3
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“For Japanese respondents, the criterion validity and high internal consistency ( α = .87) of this scale have been con ﬁ rmed (Kojima et al., 2002).”
BackgroundMethod
Depression and health-related quality of life in adolescents and young adults with childhood-onset end-stage kidney disease: a multicenter study in Japan
Miura, K., Hattori, M., Iwano, M., Inoue, E., Gotoh, Y., Okamoto, T., Nishiyama, K., Hirano, D., Nishimura, K., & Narita, I. (2023) · Clinical and Experimental Nephrology · doi:10.1007/s10157-023-02330-4 · Cited by 3
“This proportion is higher than that in the general Japanese population, which was 19% in the validation study using the Japanese version of the BDI-II questionnaire [22], Patient care teams are encouraged to regularly screen for psychological concerns and consult psychosocial providers such as psychologists and social…”
Method
A 24h Change and Reactivity in Heart Rate Variability During Games May Predict Excessive Internet Gaming : Weak Top-Down Control Among Young StudentsPreprint
Ono, Y., Ogura, M., Nakamura, K., & Kikuchi, M. (2023) · Preprints.org · doi:10.20944/preprints202304.0028.v1 · Cited by 2
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Isato, A., Aizawa, Y., Miyamae, M., & Yamada, M. (2024) · Psychological Reports · doi:10.1177/00332941241277480 · Cited by 2
“Surprisingly, BDI-II also declined in responses to the post-pandemic survey.”
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“Each item was rated on a 4-point Likert scale (ranging from 0 [“not at all”] to 3 [“most depressive”]) [14], with a total score ranging from 0 (no disturbance) to 63 (maximum depressive status), whose cutoff score of ≥ 14 indicated depressive status in patients with PD (67% sensitivity and 88%…”
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Hirayama, T., Ogawa, Y., Yanai, Y., Shindo, A., Tanaka, M., & Suzuki, S. (2023) · Palliative Medicine Reports · doi:10.1089/pmr.2023.0020 · Cited by 2
“Good reliability and validity have been reported for the Japanese version.(28) The GAD-7 is a seven-item questionnaire developed to identify probable cases of GAD and to measure the severity of GAD symptoms(29); a Japanese version has been validated.”
Pre-CBT resting-state connectivity and white matter integrity in OCD remission: A multimodal MRI study
Ikemizu, Y., Isobe, Y., Sudo, Y., Ota, J., Chhatkuli, R. B., Sasaki, T., Kurita, K., Yoshida, T., Matsumoto, K., Kuno, M., et al. (2025) · Neuroimage Reports · doi:10.1016/j.ynirp.2025.100275 · Cited by 3
“Participants also completed the Beck Depression Inventory Second Edition (Beck et al., 1996; Kojima et al., 2002) and Patient Health Questionnaire-9 (Kroenke et al., 2001; Muramatsu et al., 2018).”
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Lubliner, E., & Motta, R. W. (2011) · Cited by 2
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“The Japanese version of the BDI-II was developed by Kojima et al. (2002), who also ascertained its internal reliability and validity26).”
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“The Japanese version [22] of the Beck Depression Inventory—Second Edition (BDI-II), originally developed by Beck et al.”
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“Results have consistently shown good internal consistency and test-retest reliability of the BDI-II in community samples, (Gomes-Oliveira et al., 2012; Kojima et al., 2002; Segal et al., 2008) clinical outpatients (Grothe et al., 2005) and in clinical inpatients (Subica et al., 2014).”
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“Depressive symptoms were evaluated using the Japanese version of the Beck Depression Inventory II (BDI-II) 29 which consists of 21 items which are answered using a 4-point Likert scale.”
Influential
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“Moreover, each group was divided into two groups: low BDI-II score (≤13) [14-16] (minimal depression: Dep (-)) and the rest (mild depression: Dep (+)).”
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“Furthermore, when the studies conducted in other countries are considered, it is seen that this rate is 22% (Roberts et al., 2010); 21.5% (Lee et al., 2023) and 19.3% (Kojima et al., 2002).”
Influential

Authors: Kojima, M., Furukawa, T. A., Takahashi, H., Kawai, M., Nagaya, T., & Tokudome, S.
Affiliations: Nagoya City University (JP)
Gifu Prefectural Government (JP)
Corresponding author: Kojima, Masayo
ORCID: Kojima, Masayo
Kawai, Makoto
Tokudome, Shinkan
Venue: Psychiatry Research
Publisher: Elsevier BV
Published: 2002-07
Volume: 110
Issue: 3
Pages: 291-299
ISSN: 0165-1781 (ISSN-L)
DOI: 10.1016/s0165-1781(02)00106-3
OpenAlex: W2031252736
Cited by: 496
References: 19
Citations by year: 2026: 31 · 2025: 31 · 2024: 33 · 2023: 39 · 2022: 33 · 2021: 34 · 2020: 33 · 2019: 26 · 2018: 26 · 2017: 19 · 2016: 24 · 2015: 15 · 2014: 23 · 2013: 17 · 2012: 17
FWCI: 9.12
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Psychiatry Research (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Social Sciences › Psychology › Applied Psychology › Psychological Testing and Assessment
Keywords: Beck Depression Inventory-II, Japanese version, cross-cultural adaptation, back-translation, psychometric validation, factor structure, CES-D, depressive symptoms, gender differences in depression, internal consistency, DSM-IV diagnostic criteria
MeSH terms: Adult, Aged, Aged, 80 and over, Cross-Cultural Comparison, Depression, Factor Analysis, Statistical, Female, Humans, Japan, Male, Middle Aged, Surveys and Questionnaires, Reproducibility of Results

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Cross-cultural validation of the Beck Depression Inventory-II in Japan

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