Open AccessSubstance dependence among those without symptoms of substance abuse in the World Mental Health Survey
Author(s) -
Lago Luise,
Glantz Meyer D.,
Kessler Ronald C.,
Sampson Nancy A.,
AlHamzawi Ali,
Florescu Silvia,
Moskalewicz Jacek,
Murphy Sam,
NavarroMateu Fernando,
Torres de Galvis Yolanda,
Viana Maria Carmen,
Xavier Miguel,
Degenhardt Louisa
Publication year - 2017
Publication title -
international journal of methods in psychiatric research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.275
H-Index - 73
eISSN - 1557-0657
pISSN - 1049-8931
DOI - 10.1002/mpr.1557
Subject(s) - concordance , alcohol dependence , substance abuse , mental health , psychiatry , imputation (statistics) , cidi , substance dependence , psychology , clinical psychology , medicine , missing data , alcohol , statistics , national comorbidity survey , biochemistry , chemistry , mathematics
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.