Social Science & Medicine 61 (2005) 2280–2292 Depression in the United States and Japan: Gender, marital status, and SES patterns Akihide Inaba a , Peggy A. Thoits b,Ã , Koji Ueno c , Walter R. Gove d , Ranae J. Evenson d , Melissa Sloan d a Tokyo Metropolitan University, Tokyo, Japan b University of North Carolina Chapel Hill, NC, USA c Florida State University, USA d Vanderbilt University, USA Available online 22 August 2005 Abstract A number of investigators have claimed that higher depression scores and higher rates of depressive disorder are found worldwide in women, unmarried persons, and people of low socioeconomic status (SES). A closer look, however, indicates that patterns for Asian countries are less consistent than claimed. As a case in point, using comparable data from the National Family Research of Japan ‘98 survey (N ¼ 6985) and the National Survey of Families and Households in the US (N ¼ 8111), we examine the distributions of depressive symptoms by gender, marital status, and SES, with a short form of the CES-D Scale. Bivariate and multivariate analyses show that depressive symptoms are higher in women, unmarried persons, and those with lower family incomes in both countries, but there is no association between education and depression in Japan while symptoms are inversely related to education in the US. We argue that the lack of relationship between education and depression in Japan is not an artifact of measurement but a product of Japan’s distinctive stratification processes relating to occupation. Cross-national variations around ‘‘general’’ patterns are important because they offer clues to more specific cultural and structural factors involved in the social etiology of mental disorder. r 2005 Elsevier Ltd. All rights reserved. Keywords: Depression; Cross-cultural differences; CES-D; Japan; USA Introduction According to reviewers, most cross-cultural studies show that women, unmarried persons, and those of lower education, income, or occupational prestige have higher rates of depressive disorder and/or depressive symptoms than men, the married, and those in more advantaged socioeconomic status (SES) positions (e.g., Kohn, Dohrenwend, & Mirotznik, 1998; Nolen-Hoek- sema, 1990; Weissman et al., 1996). Although no one has claimed that these patterns are universal, reviewers usually imply that they are true in most countries. For example, Rosenfield (1989, p. 77) claims that higher depression rates in women exist ‘‘across cultures, over time, in different age groups, in rural as well as urban areas, and in treated as well as untreated populations.’’ Kohn and his colleagues (1998, p. 275) state that distributions of psychiatric disorders by gender and SES are well-established inside and outside the US, and, by implication, applicable worldwide. (See also Kessler, ARTICLE IN PRESS www.elsevier.com/locate/socscimed 0277-9536/$ - see front matter r 2005 Elsevier Ltd. All rights reserved. doi:10.1016/j.socscimed.2005.07.014 Ã Corresponding author. Tel.: +1 919 962 5605; fax: +1 919 962 7568. E-mail address: peggy.thoits@unc.edu (P.A. Thoits).