Parent-youth agreement on symptoms and diagnosis: assessment with a diagnostic interview in an adolescent inpatient clinical population.

Diagnostic information on adolescents may be elicited from both youths and their parents, especially for depressive and suicidal symptomatology. The objective of this study was to examine the degree of agreement between parent and adolescent reports of major psychiatric disorders, at the diagnostic and at the symptom level, in a severely affected inpatient clinical population. 64 parent-adolescent pairs were interviewed separately with the semi-structured diagnostic interview Kiddie-SADS-PL. Symptomatology was also assessed with 11 self-report and parent-report scales, all translated, adapted and in most cases validated in Iceland. A total of 25 subscales were included to assess emotional dimensions such as depression or anxiety and cognitive dimensions such as attention deficit or self-concept. Good agreement was found for social phobia and fair agreement for generalized anxiety disorder. Although parent-youth agreement was poor in most cases at the symptoms level, significant correlations indicated consistency for most severity scores, except those related to depressive symptomatology, attention deficit, separation anxiety or conduct disorder. The low agreement between reports of suicidal ideation is in line with results from previous studies and suggests that parents might under- or over-estimate this symptomatology. The combination of data obtained with diagnostic interviews and rating-scales confirmed results from prior empirical work, giving greater weight to parents' reports of observable behavior and to adolescents' reports of subjective experiences, especially depressive symptomatology. Our findings suggest that both parent and child informants are necessary to obtain adequate assessments in adolescents. Further research should explore the correspondence between discrepant diagnoses and external criteria such as parental psychopathology or parent-child relationships and attachment. Psychoanalysis could benefit from cognitive neuroscience and use cognitive assessments as interesting tools. Thus, cognitive assessments can show discrepant results according to parents' or adolescents' reports and can therefore shed light on the parent-child interaction and relational dynamics. Inversely, cognitive neuroscience could benefit from psychoanalysis by taking into account, when interpretating the scores, the relational dynamics and the personal history of the rater.

Validity of K-SADS-PL (Schedule for Affective Disorders and Schizophrenia for School-Age Children--Present and Lifetime Version) depression diagnoses in an adolescent clinical population.

BACKGROUND: Validity studies of the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS) interview are modest in number given the international acceptance and extensive use of this instrument in epidemiological and treatment research. The results are somewhat mixed and limited, particularly for adolescent depression. AIMS: The objective of this study was to assess the convergent-divergent validity of the screen criteria and depression diagnoses (major depressive episode) generated with the diagnostic interview Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL). METHODS: Participants were 86 consecutively admitted inpatients aged 12-17 years and their parents. Both convergent and divergent validity of the depression diagnoses were assessed against 11 standard self-report or parent-report rating scales, all of which had been translated, adapted and in most cases validated in Iceland. A total of 25 subscales were included in calculations. RESULTS: Convergent validity was confirmed, with adolescents who screened positive or met criteria for major depressive episode scoring higher than other patients did on scales assessing depressive symptoms. However, divergent validity was only partially supported in this highly comorbid inpatient sample. Severity based on number of diagnostic criteria met had a generally substantial correlation with the rating scales. CONCLUSIONS: This study provides a substantial additional amount of convergent-divergent validity data related to this extensively used diagnostic instrument.