Meyer D Glantz1, Chrianna Bharat2, Louisa Degenhardt2, Nancy A Sampson3, Kate M Scott4, Carmen C W Lim5, Ali Al-Hamzawi6, Jordi Alonso7, Laura Helena Andrade8, Graca Cardoso9, Giovanni De Girolamo10, Oye Gureje11, Yanling He12, Hristo Hinkov13, Elie G Karam14, Georges Karam15, Viviane Kovess-Masfety16, Victor Lasebikan17, Sing Lee18, Daphna Levinson19, John McGrath20, Maria-Elena Medina-Mora21, Constanta Mihaescu-Pintia22, Zeina Mneimneh23, Jacek Moskalewicz24, Fernando Navarro-Mateu25, José Posada-Villa26, Charlene Rapsey27, Juan Carlos Stagnaro28, Hisateru Tachimori29, Margreet Ten Have30, Nathan Tintle31, Yolanda Torres32, David R Williams33, Yuval Ziv34, Ronald C Kessler3. 1. Division of Epidemiology, Services, and Prevention Research (DESPR), National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH), Bethesda, MD, USA. Electronic address: mglantz@nida.nih.gov. 2. National Drug and Alcohol Research Centre (NDARC), UNSW, Sydney, Australia. 3. Department of Health Care Policy, Harvard Medical School, Boston, MA, USA. 4. Department of Psychological Medicine, University of Otago, Dunedin, Otago, New Zealand. 5. Queensland Centre for Mental Health Research and Queensland Brain Institute, The University of Queensland, St. Lucia, Queensland, Australia. 6. College of Medicine, Al-Qadisiya University, Diwaniya governorate, Iraq. 7. Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Spain; Pompeu Fabra University (UPF), Barcelona, Spain. 8. Núcleo de Epidemiologia Psiquiátrica - LIM 23, Instituto de Psiquiatria Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Brazil. 9. Lisbon Institute of Global Mental Health and Chronic Diseases Research Center (CEDOC), NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal. 10. Unit of Epidemiological and Evaluation Psychiatry, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS)-St. John of God Clinical Research Centre, Brescia, Italy. 11. FRCPsych, Department of Psychiatry, University College Hospital, Ibadan, Nigeria. 12. Shanghai Mental Health Center, Shanghai Jiao Tong University, School of Medicine, Shanghai, China. 13. National Center of Public Health and Analyses, Sofia, Bulgaria. 14. Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon. 15. Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Balamand University, Faculty of Medicine, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon. 16. Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057, Paris Descartes University, Paris, France. 17. Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria. 18. Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong. 19. Mental Health Services, Ministry of Health, Jerusalem, Israel. 20. Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland, Australia; Queensland Brain Institute, University of Queensland, St. Lucia, Queensland, Australia; National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark. 21. National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico. 22. National School of Public Health, Management and Professional Development, Bucharest, Romania. 23. Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA. 24. Institute of Psychiatry and Neurology, Warsaw, Poland. 25. UDIF-SM, Subdirección General de Planificación, Innovación y Cronicidad, Servicio Murciano de Salud, IMIB-Arrixaca, CIBERESP-Murcia, Murcia, Spain. 26. Colegio Mayor de Cundinamarca University, Faculty of Social Sciences, Bogota, Colombia. 27. PGDipClinPsych, University of Otago, Dunedin School of Medicine, Department of Psychological Medicine, New Zealand. 28. Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Buenos Aires, Argentina. 29. National Institute of Mental Health, National Center for Neurology and Psychiatry, Kodaira, Tokyo, Japan. 30. Trimbos-Instituut, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands. 31. Department of Mathematics, Statistics and Computer Science, Dordt College, Sioux Center, Iowa, USA. 32. Center for Excellence on Research in Mental Health, CES University, Medellin, Colombia. 33. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 34. Mental Health Services, Israeli Ministry of Health, 39 Yermiyahu St, Jerusalem 9101002, Israel.
Abstract
BACKGROUND: Prevalences of Alcohol Use Disorders (AUDs) and Mental Health Disorders (MHDs) in many individual countries have been reported but there are few cross-national studies. The WHO World Mental Health (WMH) Survey Initiative standardizes methodological factors facilitating comparison of the prevalences and associated factors of AUDs in a large number of countries to identify differences and commonalities. METHODS: Lifetime and 12-month prevalence estimates of DSM-IV AUDs, MHDs, and associations were assessed in the 29 WMH surveys using the WHO CIDI 3.0. RESULTS: Prevalence estimates of alcohol use and AUD across countries and WHO regions varied widely. Mean lifetime prevalence of alcohol use in all countries combined was 80%, ranging from 3.8% to 97.1%. Combined average population lifetime and 12-month prevalence of AUDs were 8.6% and 2.2% respectively and 10.7% and 4.4% among non-abstainers. Of individuals with a lifetime AUD, 43.9% had at least one lifetime MHD and 17.9% of respondents with a lifetime MHD had a lifetime AUD. For most comorbidity combinations, the MHD preceded the onset of the AUD. AUD prevalence was much higher for men than women. 15% of all lifetime AUD cases developed before age 18. Higher household income and being older at time of interview, married, and more educated, were associated with a lower risk for lifetime AUD and AUD persistence. CONCLUSIONS: Prevalence of alcohol use and AUD is high overall, with large variation worldwide. The WMH surveys corroborate the wide geographic consistency of a number of well-documented clinical and epidemiological findings and patterns.
BACKGROUND: Prevalences of Alcohol Use Disorders (AUDs) and Mental Health Disorders (MHDs) in many individual countries have been reported but there are few cross-national studies. The WHO World Mental Health (WMH) Survey Initiative standardizes methodological factors facilitating comparison of the prevalences and associated factors of AUDs in a large number of countries to identify differences and commonalities. METHODS: Lifetime and 12-month prevalence estimates of DSM-IV AUDs, MHDs, and associations were assessed in the 29 WMH surveys using the WHO CIDI 3.0. RESULTS: Prevalence estimates of alcohol use and AUD across countries and WHO regions varied widely. Mean lifetime prevalence of alcohol use in all countries combined was 80%, ranging from 3.8% to 97.1%. Combined average population lifetime and 12-month prevalence of AUDs were 8.6% and 2.2% respectively and 10.7% and 4.4% among non-abstainers. Of individuals with a lifetime AUD, 43.9% had at least one lifetime MHD and 17.9% of respondents with a lifetime MHD had a lifetime AUD. For most comorbidity combinations, the MHD preceded the onset of the AUD. AUD prevalence was much higher for men than women. 15% of all lifetime AUD cases developed before age 18. Higher household income and being older at time of interview, married, and more educated, were associated with a lower risk for lifetime AUD and AUD persistence. CONCLUSIONS: Prevalence of alcohol use and AUD is high overall, with large variation worldwide. The WMH surveys corroborate the wide geographic consistency of a number of well-documented clinical and epidemiological findings and patterns.
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