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November 24, 2004

WHO Survey of Prevalence of Mental Health Disorders—Reply

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292(20):2467-2468. doi:10.1001/jama.292.20.2468-a

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.

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