Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
In Reply: Dr Goldney and colleagues are incorrect
in their characterization of the WMH-CIDI clinical significance exclusion
rules. The exclusions they are concerned about (participants who considered
their symptoms trivial, did not consult a physician, said their symptoms did
not interfere with their life “a lot,” and did not take medication
for symptoms more than once) apply only to the original CIDI.1 The
more recent WMH-CIDI,2 which was used in the
WMH surveys, includes much more extensive questioning about distress and impairment.
Goldney and colleagues are also incorrect in their description of the WMH-CIDI
organic exclusion rules. Rather than the simple decision rules they describe,
the WMH-CIDI collects open-ended data on comorbid medical disorders and uses
case-by-case psychiatrist review to make individual exclusion decisions. Pregnancy
is not a basis for exclusion.
Kessler RC, Ustun TB. WHO Survey of Prevalence of Mental Health Disorders—Reply. JAMA. 2004;292(20):2467-2468. doi:10.1001/jama.292.20.2468-a