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In Reply: Dr Goldney and colleagues are incorrect in their characterization of the WMH-CIDI clinical significance exclusion rules. The exclusions they are concerned about (participants who considered their symptoms trivial, did not consult a physician, said their symptoms did not interfere with their life "a lot," and did not take medication for symptoms more than once) apply only to the original CIDI.¹ The more recent WMH-CIDI,² which was used in the WMH surveys, includes much more extensive questioning about distress and impairment. Goldney and colleagues are also incorrect in their description of the WMH-CIDI organic exclusion rules. Rather than the simple decision rules they describe, the WMH-CIDI collects open-ended data on comorbid medical disorders and uses case-by-case psychiatrist review to make individual exclusion decisions. Pregnancy is not a basis for exclusion.

We validated the WMH-CIDI with trained psychiatrists who recontacted subsamples of respondents and blindly administered a clinical research . . . [Full Text of this Article]

Ronald C. Kessler, PhD
Kessler@hcp.med.harvard
Harvard Medical School
Boston, Mass

T. Bedirhan Ustun, MD
World Health Organization
Geneva, Switzerland

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