Citation

Huang Y. Lancet Psychiatry 2022; 9(1): 14-15.

Copyright

(Copyright © 2022, Elsevier Publishing)

DOI

10.1016/S2215-0366(21)00465-X

PMID

34921787

Abstract

On behalf of my coauthors, I thank Yu-Tao Xiang and colleagues and Chuanyuan Kang and Jianzhong Yang and colleagues for their comments on our Article. In response to Xiang and colleagues, all surveys that are part of the World Mental Health Survey, including the China Mental Health Survey, use Composite International Diagnostic Interview (CIDI) to assess 30-day prevalence and 12-month prevalence. The two terms are different from point prevalence and 1-year prevalence. The use of 30-day and 12-month prevalence is an advance in the epidemiological investigation methods of mental disorders. In a large-scale population survey, it is difficult to conduct fieldwork on a single day as a time point, and to complete a whole survey in one calendar year. Therefore, in the China Mental Health Survey, we recorded prevalence duration from the interview day to any time in the past 12 month as 12-month prevalence and "have ever" as lifetime prevalence. Because some disorders cannot be diagnosed within 30 days, 30-day prevalence is seldom applied in most surveys using CIDI.

Xiang and colleagues mentioned that the specificity of CIDI 3.0 for major depressive disorder was only 68·6% and for dysthymia it was 72·3%. In the same paper, we reported the sensitivity of CIDI 3.0 for detecting major depressive disorder was 91·2% and for dysthymia it was 86·2%. This shows that CIDI 3.0 is an effective tool to screen for major depressive disorder and dysthymia, because it has high sensitivity. By contrast, a diagnostic tool should have high specificity. As for the low rate of treatment in the China Mental Health Survey, we believe this was due to the low reporting rate of the respondents and stigma preventing patients from seeking help from psychiatrists...

Language: en