title: Substance dependence among those without symptoms of substance abuse in the World Mental Health Survey.
abstract: The World Health Organization (WHO) World Mental Health (WMH) Survey Initiative uses the Composite International Diagnostic Interview (CIDI). The first 13 surveys only assessed substance dependence among respondents with a history of substance abuse; later surveys also assessed substance dependence without symptoms of abuse. We compared results across the two sets of surveys to assess implications of the revised logic and develop an imputation model for missing values of lifetime dependence in the earlier surveys. Lifetime dependence without symptoms of abuse was low in the second set of surveys (0.3% alcohol, 0.2% drugs). Regression-based imputation models were built in random half-samples of the new surveys and validated in the other half. There were minimal differences for imputed and actual reported cases in the validation dataset for age, gender and quantity; more mental disorders and days out of role were found in the imputed cases. Concordance between imputed and observed dependence cases in the full sample was high for alcohol [sensitivity 88.0%, specificity 99.8%, total classification accuracy (TCA) 99.5%, area under the curve (AUC) 0.94] and drug dependence (sensitivity 100.0%, specificity 99.8%, TCA 99.8%, AUC 1.00). This provides cross-national evidence of the small degree to which lifetime dependence occurs without symptoms of abuse. Imputation of substance dependence in the earlier WMH surveys improved estimates of dependence.
authors.affiliation: National Drug and Alcohol Research Centre (NDARC), UNSW, Sydney, NSW, Australia.
authors.forename: Luise
authors.initials: L
authors.lastname: Lago
authors.affiliation: Department of Epidemiology, Services, and Prevention Research (DESPR), National Institute on Drug Abuse (NIDA), National Institute of Health (NIH), Bethesda, Maryland, USA.
authors.forename: Meyer D
authors.initials: MD
authors.lastname: Glantz
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Sampson
authors.affiliation: College of Medicine, Al-Qadisiya University, Diwania Governorate, Iraq.
authors.forename: Ali
authors.initials: A
authors.lastname: Al-Hamzawi
authors.affiliation: National School of Public Health, Management and Professional Development, Bucharest, Romania.
authors.forename: Silvia
authors.initials: S
authors.lastname: Florescu
authors.affiliation: Department of Studies on Alcoholism and Drug Dependence, Institute of Psychiatry and Neurology, Warsaw, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Moskalewicz
authors.affiliation: School of Psychology, Ulster University, Coleraine, UK.
authors.forename: Sam
authors.initials: S
authors.lastname: Murphy
authors.affiliation: IMIB-Arrixaca. CIBERESP-Murcia. Subdirección General de Salud Mental y Asistencia Psiquiátrica. Servicio Murciano de Salud, El Palmar (Murcia), Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Navarro-Mateu
authors.affiliation: Center for Excellence on Research in Mental Health, CES University, Medellin, Colombia.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Torres de Galvis
authors.affiliation: Department of Social Medicine, Federal University of Espírito Santo, Vitória, Brazil.
authors.forename: Maria Carmen
authors.initials: MC
authors.lastname: Viana
authors.affiliation: Chronic Diseases Research Centre (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal.
authors.forename: Miguel
authors.initials: M
authors.lastname: Xavier
authors.affiliation: National Drug and Alcohol Research Centre (NDARC), UNSW, Sydney, NSW, Australia.
authors.forename: Louisa
authors.initials: L
authors.lastname: Degenhardt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D014943:Global Health / Q000706:statistics & numerical data*; D006306:Health Surveys / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D014944:World Health Organization; D055815:Young Adult
keywords: DSM-IV alcohol abuse; DSM-IV alcohol dependence; World Mental Health Survey; imputation; substance use disorder