The epidemiology of alcohol use disorders cross-nationally: Findings from the World Mental Health Surveys.
Level 4 - case-series / case-control
Cross-sectional survey data (graded by design analogy)
PubMed 31865172 · doi:10.1016/j.addbeh.2019.106128
What was done
Researchers analyzed data from 29 World Health Organization (WHO) World Mental Health (WMH) surveys across multiple countries and WHO regions. Using the standardized WHO Composite International Diagnostic Interview (CIDI 3.0), they assessed lifetime and 12-month prevalences of DSM-IV Alcohol Use Disorders (AUDs), comorbid Mental Health Disorders (MHDs), age-of-onset distributions, and sociodemographic correlates.
What was found
Lifetime prevalence of alcohol use averaged 80% across countries (range: 3.8% to 97.1%). In the general population, average lifetime and 12-month prevalences of AUD were 8.6% and 2.2%, respectively (10.7% and 4.4% among non-abstainers). Among individuals with lifetime AUD, 43.9% had at least one lifetime MHD, while 17.9% of individuals with an MHD had lifetime AUD; the MHD preceded the AUD in most comorbid pairings. Additionally, 15% of lifetime AUD cases began before age 18, AUD was substantially more prevalent in men, and lower risk of lifetime AUD and AUD persistence was associated with being older at interview, married, more educated, and having higher household income.
Why it matters
This study provides standardized cross-national benchmarks for AUD epidemiology, demonstrating substantial worldwide variation alongside consistent comorbidity patterns where mental health disorders typically precede AUD onset.
Limits
The abstract does not state the total participant sample size across the 29 surveys. Data rely on retrospective self-report via structured diagnostic interviews, introducing potential recall and social desirability biases. Analyses evaluated DSM-IV rather than DSM-5 diagnostic criteria.
Cited by
- contradicts Most cases of addiction and substance use disorders begin during adolescence.