The Reliability and Validity of Diagnostic Interview Schedule for Children Version IV-Korean Version (DISC-IV)

OBJECTIVES: The aim of this study was to evaluate the reliability and validity of the Korean Version of the Diagnostic Interview Schedule for Children Version IV(DISC-IV), a highly structured diagnostic interview used to assess more than 30 psychiatric disorders in children and adolescents. METHODS: A total of 91 study subjects, including 67 subjects who visited the child and adolescent psychiatry outpatient clinic at our institution and 24 community-based subjects, were assessed using the Korean Version of the DISCIV. Clinical diagnosis was used as a gold standard for the examination of the validity of the DISC-IV. Forty-four of the study subjects were randomly selected for test-retest reliability measurement. RESULTS: The validity of the Korean Version of the DISC-IV showed kappa values ranging from 0.25 to 0.40 in the clinical sample and 0.65 to 1.00 in the community sample. The sensitivities varied according to the diagnostic categories, but the specificities were excellent for all diagnostic entities. CONCLUSION: The Korean Version of the DISC-IV showed good reliability and validity in Korean children and adolescents. The Korean Version of the DISC-IV might be a useful tool for assessing psychiatric disorders in children and adolescents.

The Differences between ADHD with Bipolar Disorder Patients and ADHD Patients without Bipolar Disorder / 신경정신의학

OBJECTIVE: Attention deficit hyperactivity disorder (ADHD) is frequently comorbid with a variety of psychiatric disorders. Among them, bipolar disorder (BPD) has especially attracted growing interest. This is partly due to the fact that early onset BPD has been frequently misdiagnosed as ADHD because of symptomatic overlap. The aim of the present study is to find the differences in demographic data and clinical features of ADHD+BPD and ADHD in children and adolescents. METHOD: Children and adolescents patients participating in the present study have been enrolled at the child psychiatric clinic since 2004. 14 patients meeting the DSM-IV criteria for ADHD+BPD and 19 patients meeting the criteria for ADHD and 15 healthy comparison subjects were recruited. All groups were evaluated through the Schedule for Affective disorders and Schizophrenia for School-Age Children-Present and Life Time version-Korean version (K-SADS-PL-K). Demographic data and clinical characteristics of the subjects were also collected. Parents were asked to complete the Child Behavior Check List (CBCL) and the Toddler Temperamental Scale (TTS) clinical ratings were obtained using the Young Mania Rating Scale (YMRS), the Children's Depression Iventory (CDI) and the Dupaul ADHD scale. Clinical variables between ADHD+BPD and ADHD were analyzed using the Mann-Whitney U test. YMRS, CDI, Dupaul ADHD scale (inattention and hyperactivity), CBCL, and TTS among the three groups were analyzed using the Kruskal-Wallis test with post-hoc Mann-Whitney U test. RESULTS: 1) ADHD+BPD group had an earlier onset age of ADHD than ADHD group 2) ADHD+BPD group had more co-morbid psychiatric disorders than ADHD group. 3) Compared to ADHD group, ADHD+BPD had more psychiatric family history, especially mood disorders. 4) ADHD+BPD group had prodromal symptoms such as irritability, anger dyscontrol and academic dysfunction, compared to ADHD group who rarely showed prodromal symptoms. 5) ADHD+BPD group had higher ADHD scores than the ADHD group in the Dupaul ADHD inattentive scale. 6) In global functions of CBCL, ADHD+BPD group showed more impaired functions at home and school than ADHD group. 7) In Attention diagnostic system (ADS), ADHD+BPD group had more omission and commission errors than ADHD group, especially in the visual system. 8) In the subtests of the IQ profile, ADHD+BPD group had lower arithmetic and block design scores than ADHD group. CONCLUSION: Clinicians have to rule out underlying bipolarity in children and adolescents with ADHD who show earlier age of onset and severe clinical features. Bipolarity should be explored intensively in ADHD children and adolescents who have early onset of symptoms and severe functional impairment.