title: Alcohol abuse in developed and developing countries in the World Mental Health Surveys: Socially defined consequences or psychiatric disorder?
abstract: BACKGROUND
  Previous single country research has raised concerns that: (1) the DSM-IV diagnosis of alcohol abuse (AA) is met primarily through the hazardous use criterion related to drinking and driving and (2) that the hazardous use and social consequences AA criteria primarily reflect varying socioeconomic and cultural factors rather than psychiatric disorder.
  
  
  METHODS
  Using representative cross-national data from the 21 countries in the World Mental Health surveys, adults meeting DSM-IV lifetime criteria for AA but not dependence from 10 developed (n=46,071) and 11 developing (n=49,761) countries were assessed as meeting AA with the hazardous use or the social consequences criteria.
  
  
  RESULTS
  Between 29.3% (developed) and 16.2% (developing) of respondents with AA met only the hazardous use criterion. AA cases with and without hazardous use were similar in age-of-onset, course, predictors, and psychopathological consequences in both developed and developing countries.
  
  
  CONCLUSIONS
  Despite some associations of the AA criteria with socioeconomic factors, the hazardous use and social consequences criteria were significantly associated with psychiatric predictors and sequelae. The findings indicate that these criteria reflect psychiatric disorder and are appropriate for inclusion as DSM-5 Alcohol Use Disorder criteria.
  
  
  CONCLUSIONS
  These findings support a psychiatric rather than a sociocultural view of the hazardous use and social consequences symptoms and provide evidence that they are appropriate diagnostic criteria cross-nationally with utility in a wide range of socioeconomic environments. This suggests consideration for their adoption by ICD-11. Further research is needed on the implications of these results for prevention and treatment.
authors.affiliation: Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland.
authors.forename: Meyer D
authors.initials: MD
authors.lastname: Glantz
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Medina-Mora
authors.forename: Maria
authors.initials: M
authors.lastname: Petukhova
authors.forename: Laura Helena
authors.initials: LH
authors.lastname: Andrade
authors.forename: James C
authors.initials: JC
authors.lastname: Anthony
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Girolamo
authors.forename: Ron
authors.initials: R
authors.lastname: de Graaf
authors.forename: Louisa
authors.initials: L
authors.lastname: Degenhardt
authors.forename: Koen
authors.initials: K
authors.lastname: Demyttenaere
authors.forename: Silvia
authors.initials: S
authors.lastname: Florescu
authors.forename: Oye
authors.initials: O
authors.lastname: Gureje
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Haro
authors.forename: Itsuko
authors.initials: I
authors.lastname: Horiguchi
authors.forename: Elie G
authors.initials: EG
authors.lastname: Karam
authors.forename: Stanislav
authors.initials: S
authors.lastname: Kostyuchenko
authors.forename: Sing
authors.initials: S
authors.lastname: Lee
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Lépine
authors.forename: Herbert
authors.initials: H
authors.lastname: Matschinger
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Neumark
authors.forename: Jose
authors.initials: J
authors.lastname: Posada-Villa
authors.forename: Rajesh
authors.initials: R
authors.lastname: Sagar
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
authors.forename: Toma
authors.initials: T
authors.lastname: Tomov
authors.forename: J Elisabeth
authors.initials: JE
authors.lastname: Wells
authors.forename: Somnath
authors.initials: S
authors.lastname: Chatterji
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D000437:Alcoholism / Q000175:diagnosis* / Q000453:epidemiology*; D019049:Developed Countries / Q000706:statistics & numerical data*; D003906:Developing Countries / Q000706:statistics & numerical data*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult