Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Association of response rate and prevalence estimates of common mental disorders across 129 areas in a nationally representative survey of adults in Japan

  • 38 Accesses



To investigate the association of area response rate with prevalence estimates of mental disorders in the 2nd World Mental Health Survey (WMHJ2).


The sample of the WMHJ2 was selected from community residents in 129 areas from three regions of Japan. The surveys were conducted between 2013 and 2015, and 2450 (43.4%) responded. Mental disorders as well as three disorder classes (mood, anxiety, and substance use disorders) were identified using the WHO CIDI/DSM-IV. Response rates and 12-month and lifetime prevalences were calculated for each area. A generalized linear mixed model analysis was conducted to associate area response rate with the prevalence of mental disorders, controlling for sex, age, urbanity, and geographical region.


Area response rates ranged from 0.05 to 0.80 across the 129 areas. Area response rate was not significantly associated with 12-month or lifetime prevalence of mental disorder. Lifetime prevalences of substance use disorder were significantly lower in a survey with a higher response rate than a survey of the same area with a lower response rate.


Response rate may not strongly affect the prevalence estimates of mental disorders in a community-based survey of the prevalence of common mental disorders during a particular time frame. However, a lower response rate could be associated with overestimation of lifetime prevalence of substance use disorder. This needs further elucidation.

This is a preview of subscription content, log in to check access.

Fig. 1


  1. 1.

    Demyttenaere K, Bruffaerts R, Posada-Villa J, Gasquet I, Kovess V, Lepine J, Angermeyer M, Bernert S, de Girolamo G, Morosini P, Polidori G, Kikkawa T, Kawakami N, Ono Y, Takeshima T, Uda H, Karam E, Fayyad J, Karam A, Mneimneh Z, Medina-Mora M, Borges G, Lara C, de Graaf R, Ormel J, Gureje O, Shen Y, Huang Y, Zhang M, Alonso J, Haro J, Vilagut G, Bromet E, Gluzman S, Webb C, Kessler R, Merikangas K, Anthony J, Von Korff M, Wang P, Brugha T, Aguilar-Gaxiola S, Lee S, Heeringa S, Pennell B, Zaslavsky A, Ustun T, Chatterji S, Conso WWMHS (2004) Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA 291(21):2581–2590

  2. 2.

    Steel Z, Marnane C, Iranpour C, Chey T, Jackson J, Patel V, Silove D (2014) The global prevalence of common mental disorders: a systematic review and meta-analysis 1980–2013. Int J Epidemiol 43(2):476–493

  3. 3.

    Galea S, Tracy M (2007) Participation rates in epidemiologic studies. Ann Epidemiol 17(9):643–653

  4. 4.

    Hansen V, Jacobsen B, Arnesen E (2001) Prevalence of serious psychiatric morbidity in attenders and nonattenders to a health survey of a general population—the Tromso Health Study. Am J Epidemiol 154(10):891–894

  5. 5.

    Bootsma-van der Wiel A, van Exel E, de Craen A, Gussekloo J, Lagaay A, Knook D, Westendorp R (2002) A high response is not essential to prevent selection bias: results from the Leiden 85-plus study. J Clin Epidemiol 55(11):1119–1125

  6. 6.

    Cheung K, ten Klooster P, Smit C, de Vries H, Pieterse M (2017) The impact of non-response bias due to sampling in public health studies: a comparison of voluntary versus mandatory recruitment in a Dutch national survey on adolescent health. BMC Public Health 17:276

  7. 7.

    de Winter A, Oldehinkel A, Veenstra R, Brunnekreef J, Verhulst F, Ormel J (2005) Evaluation of non-response bias in mental health determinants and outcomes in a large sample of pre-adolescents. Eur J Epidemiol 20(2):173–181

  8. 8.

    Haapea M, Miettunen J, Laara E, Joukamaa M, Jarvelin M, Isohanni M, Veijola J (2008) Non-participation in a field survey with respect to psychiatric disorders. Scand J Public Health 36(7):728–736

  9. 9.

    Lundberg I, Thakker K, Hallstrom T, Forsell Y (2005) Determinants of non-participation, and the effects of non-participation on potential cause-effect relationships, in the PART study on mental disorders. Soc Psychiatry Psychiatr Epidemiol 40(6):475–483

  10. 10.

    VonKorff M, Cottler L, George LK, Eaton WW, Leaf PJ, Burnam A (1985) Nonresponse and nonresponse bias in the ECA surveys. In: Eaton WW, Kessler LG (eds) Epidemiologic field methods in psychiatry. Academic, Cambridge, pp 85–98. https://doi.org/10.1016/B978-0-08-091798-6.50009-9

  11. 11.

    Korkeila K, Suominen S, Ahvenainen J, Ojanlatva A, Rautava P, Helenius H, Koskenvuo M (2001) Non-response and related factors in a nation-wide health survey. Eur J Epidemiol 17(11):991–999

  12. 12.

    Kessler RC, Ustun TB (2004) The world mental health (WMH) survey initiative version of the world health organization (WHO) composite international diagnostic interview (CIDI). Int J Methods Psychiatr Res 13(2):93–121

  13. 13.

    Ferrari A, Somerville A, Baxter A, Norman R, Patten S, Vos T, Whiteford H (2013) Global variation in the prevalence and incidence of major depressive disorder: a systematic review of the epidemiological literature. Psychol Med 43(3):471–481

  14. 14.

    Ishikawa H, Tachimori H, Takeshima T, Umeda M, Miyamoto K, Shimoda H, Baba T, Kawakami N (2018) Prevalence, treatment, and the correlates of common mental disorders in the mid 2010's in Japan: the results of the world mental health Japan 2nd survey. J Affect Dis 241:554–562

  15. 15.

    Haro JM, Arbabzadeh-Bouchez S, Brugha TS, de Girolamo G, Guyer ME, Jin R, Lepine JP, Mazzi F, Reneses B, Vilagut G, Sampson NA, Kessler RC (2006) Concordance of the Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) with standardized clinical assessments in the WHO World Mental Health surveys. Int J Methods Psychiatr Res 15(4):167–180

  16. 16.

    Kawakami N, Takeshima T, Ono Y, Uda H, Hata Y, Nakane Y, Nakane H, Iwata N, Furukawa TA, Kikkawa T (2005) Twelve-month prevalence, severity, and treatment of common mental disorders in communities in Japan: preliminary finding from the World Mental Health Japan Survey 2002–2003. Psychiatry Clin Neurosci 59(4):441–452

  17. 17.

    American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington, DC

  18. 18.

    Lee S, Brown ER, Grant D, Belin TR, Brick JM (2009) Exploring nonresponse bias in a health survey using neighborhood characteristics. Am J Public Health 99(10):1811–1817

  19. 19.

    Peen J, Dekker J, Schoevers R, ten Have M, de Graaf R, Beekman A (2007) Is the prevalence of psychiatric disorders associated with urbanization? Soc Psychiatry Psychiatr Epidemiol 42(12):984–989

  20. 20.

    Yasuma N, Watanabe K, Nishi D, Ishikawa H, Tachimori H, Takeshima T, Umeda M, Sampson L, Galea S, Kawakami N (2019) Urbanization and Internet addiction in a nationally representative sample of adult community residents in Japan: a cross-sectional, multilevel study. Psychiatry Res 273:699–705

  21. 21.

    Gowin J, Sloan ME, Swan JE, Momenan R, Ramchandani VA (2019) The relationship between delay discounting and alcohol dependence in individuals with and without comorbid psychopathology. Psychopharmacology 236(2):775–785

  22. 22.

    Griffiths KM, Nakane Y, Christensen H, Yoshioka K, Jorm AF, Nakane H (2006) Stigma in response to mental disorders: a comparison of Australia and Japan. BMC Psychiatry 6:21

  23. 23.

    De Silva MJ, McKenzie K, Harpham T, Huttly SRA (2005) Social capital and mental illness: a systematic review. J Epidemiol Community Health 59(8):619–627

Download references


The World Mental Health Japan Second Survey was supported by a Grant for Research on Psychiatric and Neurological Diseases and Mental Health from the Japan Ministry of Health, Labour, and Welfare (H25-SEISHIN-IPPAN006) and by Research and Development Grants for Comprehensive Research for Persons with Disabilities from the Japan Agency for Medical Research and Development (15dk0310020h0003). The overall WMHS was supported by the US National Institute of Mental Health (R01 MH070884), the MacArthur Foundation, the Pfizer Foundation, the US Public Health Service (R13-MH066849, R01-MH069864 and R01 DA016558), the Fogarty International Center (R03-TW006481), the Pan American Health Organization, Eli Lilly and Company, Ortho-McNeil Pharmaceutical Inc., GlaxoSmithKline, Bristol-Myers Squibb, and Shire. The funders had no role in analyzing or interpreting the data.

Author information

Correspondence to Norito Kawakami.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Kawakami, N., Yasuma, N., Watanabe, K. et al. Association of response rate and prevalence estimates of common mental disorders across 129 areas in a nationally representative survey of adults in Japan. Soc Psychiatry Psychiatr Epidemiol (2020). https://doi.org/10.1007/s00127-020-01847-3

Download citation


  • Cross-sectional study
  • Non-response
  • Substance use disorder
  • Lifetime prevalence
  • Hierarchical model