Concordance between the diagnostic guidelines for alcohol and cannabis use disorders in the draft ICD-11 and other classification systems: analysis of data from the WHO's World Mental Health Surveys

Author(s):Show less -

Bharat, Chrianna ^[1] ; Bruno, Raimondo ^[2] ; Glantz, Meyer D. ^[3] ; Sampson, Nancy A. ^[4] ; Lago, Luise ^[1] ; Bunting, Brendan ; Caldas-de-Almeida, Jose Miguel ^{[5, 6]} ; Khalaf, Mohammad ^[7] ; McGrath, John J. ^{[8, 9, 10]} ; Sasu, Carmen C. ^[11] ; Scott, Kate ^[12] ; Poznyak, Vladimir ^[13] ; Aguilar-Gaxiola, Sergio ^[14] ; Al-Hamzawi, Ali ; Al-Kaisy, Mohammed Salih ; Alonso, Jordi ^{[15, 16, 17, 18]} ; Andrade, Laura Helena ^[19] ; Benjet, Corina ; Borges, Guilherme ; Bromet, Evelyn J. ; Bruffaerts, Ronny ; Caldas de Almeida, Jose Miguel ; Cardoso, Graca ; Chatterji, Somnath ^[20] ; Cia, Alfredo H. ^[21] ; Degenhardt, Louisa ^[1] ; Demyttenaere, Koen ; Fayyad, John ; Florescu, Silvia ; de Girolamo, Giovanni ; Gureje, Oye ^[22] ; Haro, Josep Maria ; He, Yanling ; Hinkov, Hristo ; Hu, Chi-yi ; Huang, Yueqin ; de Jonge, Peter ; Karam, Aimee Nasser ; Karam, Elie G. ^{[23, 24, 25]} ; Kawakami, Norito ; Kessler, Ronald C. ^[4] ; Kiejna, Andrzej ; Kovess-Masfety, Viviane ; Lee, Sing ^[26] ; Lepine, Jean-Pierre ; Levinson, Daphna ; McGrath, John ; Medina-Mora, Maria Elena ; Mneimneh, Zeina ^[27] ; Moskalewicz, Jacek ^[28] ; Navarro-Mateu, Fernando ^{[29, 30, 31]} ; Pennell, Beth-Ellen ; Piazza, Marina ; Posada-Villa, Jose ; Scott, Kate M. ; Slade, Tim ; Stagnaro, Juan Carlos ; Stein, Dan J. ; ten Have, Margreet ; Torres, Yolanda ^[32] ; Viana, Maria Carmen ; Whiteford, Harvey ; Williams, David R. ; Wojtyniak, Bogdan ; Colla, WHO World Mental Hlth Survey

Affiliation:Show less -

^[1] UNSW, Natl Drug & Alcohol Res Ctr, Randwick, NSW - Australia

^[2] Univ Tasmania, Sch Med Psychol, Hobart, Tas - Australia

^[3] Natl Inst Drug Abuse, DESPR, NIH, Bethesda, MD - USA

^[4] Harvard Med Sch, Dept Hlth Care Policy, Boston, MA - USA

^[5] Univ Nova Lisboa, NOVA Med Sch, Fac Ciencias Med, Lisbon Inst Global Mental Hlth, Lisbon - Portugal

^[6] Univ Nova Lisboa, NOVA Med Sch, Fac Ciencias Med, Chron Dis Res Ctr CEDOC, Lisbon - Portugal

^[7] Ibn Sina Teaching Hosp, Mosul - Iraq

^[8] Queensland Ctr Mental Hlth Res, Pk Ctr Mental Hlth, Wacol - Australia

^[9] Univ Queensland, Queensland Brain Inst, St Lucia, Qld - Australia

^[10] Aarhus Univ, Natl Ctr Register based Res, Aarhus - Denmark

^[11] Natl Sch Publ Hlth Management & Profess Dev, Bucharest - Romania

^[12] Univ Otago, Dept Psychol Med, Dunedin, Otago - New Zealand

^[13] World Hlth Org, Dept Mental Hlth & Substance Abuse, Geneva - Switzerland

^[14] UC Davis Hlth Syst, Ctr Reducing Hlth Dispar, Sacramento, CA - USA

^[15] CIBER Epidemiol & Salud Publ CIBERESP, Barcelona - Spain

^[16] Pompeu Fabra Univ, Barcelona - Spain

^[17] IMIM, Hlth Serv Res Unit, Hosp del Mar, Med Res Inst, Barcelona - Spain

^[18] Univ Sao Paulo, Inst Psiquiatria Hosp Clin, Fac Med, Nucleo Epidemiol Psiquiatr LIM 23, Sao Paulo - Brazil

^[19] Univ Ulster, Sch Psychol, Coleraine, Londonderry - North Ireland

^[20] World Hlth Org, Dept Informat Evidence & Res, Geneva - Switzerland

^[21] Anxiety Disorders Ctr, Buenos Aires, DF - Argentina

^[22] Univ Coll Hosp, Dept Psychiat, Ibadan - Nigeria

^[23] IDRAAC, Beirut - Lebanon

^[24] St George Hosp Univ Med Ctr, Dept Psychiat & Clin Psychol, Beirut - Lebanon

^[25] Balamand Univ, Dept Psychiat & Clin Psychol, Fac Med, Beirut - Lebanon

^[26] Chinese Univ Hong Kong, Dept Psychiat, Tai Po, Hong Kong - Peoples R China

^[27] Univ Michigan, Inst Social Res, Survey Res Ctr, Ann Arbor, MI - USA

^[28] Inst Psychiat & Neurol, Warsaw - Poland

^[29] IMIB Arrixaca, Murcia - Spain

^[30] Serv Murciano Salud, UDIF SM, Murcia - Spain

^[31] CIBER Epidemiol & Salud Publ CIBERESP, Murcia - Spain

^[32] CES Univ, Ctr Excellence Res Mental Hlth, Medellin - Colombia

• Document type: Journal article
• Source: ADDICTION; v. 114, n. 3, p. 534-552, MAR 2019.
• Web of Science Citations: 6

Abstract

Background and aims The World Health Organization's (WHO's) proposed International Classification of Diseases, 11th edition (ICD-11) includes several major revisions to substance use disorder (SUD) diagnoses. It is essential to ensure the consistency of within-subject diagnostic findings throughout countries, languages and cultures. To date, agreement analyses between different SUD diagnostic systems have largely been based in high-income countries and clinical samples rather than general population samples. We aimed to evaluate the prevalence of, and concordance between diagnoses using the ICD-11, The WHO's ICD 10th edition (ICD-10) and the Diagnostic and Statistical Manual of Mental Disorders, 4th and 5th editions (DSM-IV, DSM-5); the prevalence of disaggregated ICD-10 and ICD-11 symptoms; and variation in clinical features across diagnostic groups. Design Cross-sectional household surveys. Setting Representative surveys of the general population in 10 countries (Argentina, Australia, Brazil, Colombia, Iraq, Northern Ireland, Poland, Portugal, Romania and Spain) of the World Mental Health Survey Initiative. Participants Questions about SUDs were asked of 12 182 regular alcohol users and 1788 cannabis users. Measurements Each survey used the World Mental Health Survey Initiative version of the WHO Composite International Diagnostic Interview version 3.0 (WMH-CIDI). Findings Among regular alcohol users, prevalence (95% confidence interval) of life-time ICD-11 alcohol harmful use and dependence were 21.6% (20.5-22.6%) and 7.0% (6.4-7.7%), respectively. Among cannabis users, 9.3% (7.4-11.1%) met criteria for ICD-11 harmful use and 3.2% (2.3-4.0%) for dependence. For both substances, all comparisons of ICD-11 with ICD-10 and DSM-IV showed excellent concordance (all kappa >= 0.9). Concordance between ICD-11 and DSM-5 ranged from good (for SUD and comparisons of dependence and severe SUD) to poor (for comparisons of harmful use and mild SUD). Very low endorsement rates were observed for new ICD-11 feature for harmful use ('harm to others'). Minimal variation in clinical features was observed across diagnostic systems. Conclusions The World Health Organization's proposed International Classification of Diseases, 11th edition (ICD-11) classifications for substance use disorder diagnoses are highly consistent with the ICD 10th edition and the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). Concordance between ICD-11 and the DSM 5th edition (DSM-5) varies, due largely to low levels of agreement for the ICD harmful use and DSM-5 mild use disorder. Diagnostic validity of self-reported `harm to others' is questionable. (AU)

• FAPESP's process: 03/00204-3 - Epidemiological study of psychiatric disorders in the São Paulo Metropolitan Region: prevalence, risk factors, and social and economical burden
• Grantee: Laura Helena Silveira Guerra de Andrade
• Support Opportunities: Research Projects - Thematic Grants