Introduction: Structured interviews are often used in epidemiological studies to estimate diagnostic prevalence, and in clinical research studies to assign psychiatric diagnoses. Meanwhile, clinicians in standard practice often employ a variety of diagnostic assessment methods, frequently not involving structured interviews. There is limited empirical data concerning the agreement between structured diagnostic interviews and clinician-based diagnoses, especially in the child and adolescent population. Method: Participants in this study included 254 children and adolescents ages 6-18 (M=13.6, SD=2.98) who had utilized public mental health services in one county. All youth were evaluated by a mental health professional within one year prior to administration of the Diagnostic Interview Schedule for Children - IV (DISC-IV), and received at least one diagnosis from the clinician. Past-year prevalence rates were determined for four major diagnostic categories (Anxiety, Mood, Attention-Deficit/Hyperactivity Disorder (ADHD), and disruptive behavior disorders). Kappa statistics were calculated to compare agreement between clinician and DISC diagnoses for each of these categories. Results: Overall, Kappas were below the guideline for poor agreement (0.40), ranging from -0.04 for anxiety disorders to 0.22 for ADHD. Follow-up analyses explored potential moderators of agreement between the DISC-IV and clinicians, including etiological factors. Implications: The diagnosis a child receives has potential implications for the type of psychotherapeutic treatment and/or medication provided. This work highlights the need for a better understanding of factors that affect the assignment of diagnoses under different methods. This is especially true if researchers continue to use structured interviews to determine prevalence and to communicate diagnosis-based treatment guidelines.
Learning Objectives: 1. Discuss the prevalence of psychiatric diagnoses assigned by a clinician and how they differ from rates of diagnoses assigned by a structured interview. 2. Describe the rates of agreement between psychiatric diagnoses assigned by a clinician with those assigned by a structured interview.
Keywords: Adolescents, Mental Health
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.