Usefulness of the Brief Job Stress Questionnaire to identify employees at risk of depression in the Japanese Stress Check Program: a large-scale cross-sectional study

Objectives: The Japanese National Stress Check Program recommends the Brief Job Stress Questionnaire (BJSQ) for annual psychosocial assessments in the workplace. We examined the performance of this instrument in screening depression. Methods: We conducted an online cross-sectional study involving 25,000 employees in October 2024. Participants completed the BJSQ and the nine-item Patient Health Questionnaire (PHQ-9). We conducted receiver operating characteristic curve analyses to estimate the screening performance of the BJSQ cutoff points recommended in the Stress Check Program manual. Results: The prevalence of workers with potential depression (PHQ-9 score ≥10) was 25.9%. The prevalence of "high-risk" employees defined using the BJSQ criteria recommended in the Program manual was 18.8%, with sensitivity of 50.9%, specificity of 92.4%, Youden index of 0.433, area under the curve of 0.716, positive predictive value of 70.0%, negative predictive value of 84.8%, and positive and negative likelihood ratios of 6.7 and 0.5, respectively. Conclusion: Identifying "high stress" employees as per the Stress Check Program manual recommendation is informative to screen employees with potential depression provided that appropriate follow-up is undertaken. When using this information, practitioners should consider its limitations as a screening tool.