Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
To the Editor: We are concerned that the prevalences
of mental health disorders presented in the tables from the World Health Organization
(WHO) World Mental Health (WMH) Survey Consortium1 may
be underestimates because of the characteristics of the instrument used in
their survey, the Composite International Diagnostic Interview (CIDI).2 While the authors noted that the “CIDI organic
exclusion rules were imposed in making all diagnoses,” presumably precluding
mood disorders associated with substances such as alcohol and other drugs,
as well as those asssociated with physical illness and injury, they did not
indicate that the CIDI also excludes data from those respondents who consider
their symptoms to be trivial or who have not consulted a physician; those
who report that their symptoms do not interfere “a lot” with their
everyday life and activity (as determined by the respondent); and those who
have not taken medication for their symptoms on more than 1 occasion.
Goldney RD, Fisher LJ, Hawthorne G. WHO Survey of Prevalence of Mental Health Disorders. JAMA. 2004;292(20):2467-2468. doi:10.1001/jama.292.20.2467-c