Diagnostic Interview Schedule For Children Version IV Research Articles

28.5 Co-Occurrence of ADHD, Disruptive Behavior Disorders, Anxiety, and Depression in School-Aged Youth: Project to Learn About Youth-Mental Health

The objective of this presentation is to understand the prevalence of co-occurring mental disorders as determined by a DSM-IV criteria–based approach to disorder ascertainment among a K-12 sample of children, drawn from a single school district in each of 4 states: Colorado, Florida, Ohio, and South Carolina. This study used data from the Project to Learn About Youth – Mental Health (PLAY-MH), which utilized a 2-stage design. First, teachers completed screening tools to classify a child as high vs low risk for externalizing, internalizing, or tic disorders. Parents of children who were selected into stage 2 participated in one-on-one interviews, including the Diagnostic Interview Schedule for Children, version IV (DISC-IV) to identify those who met criteria for one or more disorders. Analyses were restricted to 305 children with at least 1 disorder and used SAS v9.4 survey procedures (SAS Institute, Inc.; Cary, NC) to account for the complex sample design and produce weighted percentages and 95% CI; comparisons with nonoverlapping CIs are described as being different. Co-occurring disorders were present in over half of children with each disorder examined (51.7%, CI 40.0-63.3 for disruptive behavior disorders; 54.5%, CI 41.4-67.6 for ADHD; 58.4%, CI 43.9-72.8 for anxiety disorders; 90.3%, CI 80.3-100 for depressive disorders). Among children with an anxiety disorder, boys were more likely than girls to have a disruptive behavior disorder, children aged 5 to 11 years were more likely than children older than 12 years to have ADHD, and non-Hispanic White children were more likely than Hispanic children or children of another race/ethnicity (not including Black) to have a disruptive behavior disorder. Among children with a disruptive behavior disorder, non-Hispanic White children were more likely than Hispanic children or children of another race/ethnicity (not including Black) to also have an anxiety disorder. Mental disorder co-occurrence in the PLAY-MH sample is prevalent, particularly among children with a depressive disorder, with unique patterns of co-occurrence by disorder type and clinical and demographic characteristics. These results can be used in conjunction with other modes of mental disorder surveillance to inform mental health screening, treatment, and educational services.

The factor structure and predictive validity of the Kessler Psychological Distress Scale (K10) in children and adolescents

ObjectiveTo systematically investigate the factor structure and predictive validity of the Kessler‐10 (K10) in an Australian child and adolescent population.MethodConfirmatory factor analyses were undertaken on data from 2,967 youth aged 11–17-years from the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Receiver operating characteristic analyses and penalised logistic regressions were used to explore the ability of K10 factor scores to predict Diagnostic Interview Schedule for Children Version IV (DISC‐IV) identified mental disorders.ResultsA bifactor model with two‐group factors (Anxiety and Depression) provided the best fit for youth with past‐month mental disorders. A four‐factor solution (Nervousness, Agitation, Fatigue, and Negative Affect) fit best for youth without past‐year mental disorders; however bifactor analyses indicated that these factors accounted for little common variance after controlling for the effects of general distress. When controlling for age and gender, Agitation factor scores predicted DISC‐IV behavioural disorder diagnoses and neither Anxiety scores nor Nervousness scores were predictive of DISC‐IV diagnosed social phobia, separation anxiety, obsessive–compulsive disorder, casting doubt over the suitability of K10 items to capture anxiety symptoms in youth.ConclusionThe K10 is “unidimensional enough” in the Australian child and adolescent community population. Associations between K10 and mental disorders are mainly represented by items comprising Negative Affect and Agitation factors, which raises the possibility that briefer versions might be equally useful, either for capturing the general distress factor or a version that is more predictive of mental disorders in youth.

Has the Prevalence of Child and Adolescent Mental Disorders in Australia Changed Between 1998 and 2013 to 2014?

This study examined whether the 12-month prevalence of major depressive disorder (MDD), attention-deficit/hyperactivity disorder (ADHD), and conduct disorder (CD) among 6- to 17-year-olds in Australia changed between 1998 and 2013 to 2014. It also investigated whether changes in the prevalence of disorders over this time varied for children living in families containing 2 parents versus single parents, and families with high versus low income. The study used data from national surveys conducted in Australia in 1998 (N= 3,597) and 2013 to 2014 (N= 5,359). In both surveys, the participating individuals were randomly selected from all 6- to 17-year-olds in Australia, and mental disorders were assessed using the Diagnostic Interview Schedule for Children Version IV (DISC-IV), completed by parents. There was little change in the overall prevalence of mental disorders between 1998 (12.5%, 95% CI= 11.4-13.7) and 2013 to 2014 (11.1%, 95% CI= 10.1-12.2). Although there were some differences in the changes for children with different disorders, most were small in magnitude. Specifically, MDD prevalence increased from 2.1% (95% CI= 1.7-2.7) to 3.2% (95% CI= 2.7-3.8), ADHD prevalence declined from 9.9% (95% CI= 8.9-10.9) to 7.8% (95% CI= 6.9-8.7), and CD prevalence declined from 2.7% (95% CI= 2.2-3.3) to 2.1% (95% CI=1.7-2.7). There was a persisting pattern of higher prevalence among children living in single-parent and low-income households. Lack of change at a population level in the prevalence of child mental disorders suggests that new innovations in research, policy, and practice are needed to successfully address the major public health problem posed by child and adolescent mental disorders in the community.

Do post-trauma symptoms mediate the relation between neurobiological stress parameters and conduct problems in girls?

ObjectiveAttenuated activity of stress-regulating systems has consistently been reported in boys with conduct problems. Results in studies of girls are inconsistent, which may result from the high prevalence of comorbid post-trauma symptoms. Therefore, the aim of the present study is to investigate post-trauma symptoms as a potential mediator in the relation between stress-regulation systems functioning and conduct problems in female adolescents.MethodsThe sample consisted of 78 female adolescents (mean age 15.4; SD 1.1) admitted to a closed treatment institution. The diagnosis of disruptive behaviour disorder (DBD) was assessed by a structured interview—the diagnostic interview schedule for children version IV (DISC-IV). To assess post-trauma symptoms and externalizing behaviour problems, self-report questionnaires, youth self report (YSR) and the trauma symptom checklist for Children (TSCC) were used. The cortisol awakenings response (CAR) measured hypothalamic–pituitary–adrenal (HPA) axis activity, whereas autonomous nervous system (ANS) activity was assessed by heart rate (HR), pre-ejection period (PEP) and respiratory sinus arrhythmia (RSA). Independent t-tests were used to compare girls with and without DBD, while path analyses tested for the mediating role of post- trauma symptoms in the relation between stress regulating systems and externalizing behaviour.ResultsFemales with DBD (n = 37) reported significantly higher rates of post-trauma symptoms and externalizing behaviour problems than girls without DBD (n = 39). Path analysis found no relation between CAR and externalizing behaviour problems. With regard to ANS activity, positive direct effects on externalizing behaviour problems were present for HR (standardized β = 0.306, p = 0.020) and PEP (standardized β = −0.323, p = 0.031), though not for RSA. Furthermore, no relation—whether direct or indirect—could be determined from post-trauma symptoms.ConclusionsPresent findings demonstrate that the neurobiological characteristics of female externalizing behaviour differ from males, since girls showed heightened instead of attenuated ANS activity. While the prevalence of post-trauma symptoms was high in girls with DBD, it did not mediate the relation between stress parameters and externalizing behaviour. Clinical implications and future directions are discussed.

The Prevalence of Stimulant and Antidepressant Use by Australian Children and Adolescents with Attention-Deficit/Hyperactivity Disorder and Major Depressive Disorder: A National Survey.

To identify the prevalence of stimulant and antidepressant medication use by children and adolescents with symptoms meeting the criteria for attention-deficit/hyperactivity disorder (ADHD) and major depressive disorder (MDD) in Australia. To identify factors associated with stimulant and antidepressant use by children and adolescents in Australia. Data are from a nationally representative sample of 4- to 17-year-olds (n = 6310). Parents completed the Diagnostic Interview Schedule for Children-Version IV (DISC-IV) and the Strengths and Difficulties Questionnaire. Eleven- to 17-year-olds completed a self-report version of the DISC-IV MDD module. Interviewers recorded prescribed medications used by participants in the previous 2 weeks. During a 2-week period, 1.3% of all 4- to 17-year-olds and 13.7% of those with symptoms meeting the criteria for ADHD had used stimulant medication, while 0.9% of all 4- to 17-year-olds and 13.4% with MDD had used antidepressants. In total, 22.6% of those using stimulant medications and 57.7% using antidepressant medications did not have symptoms meeting criteria for ADHD or MDD, respectively. Among 11- to 17-year-olds, 5.6% of those with adolescent-only-reported MDD, 10.9% of those with parent/carer-only-reported MDD, and 25.7% of those with MDD reported by both parents/carers and adolescents were using antidepressant medications. Only a minority of 4- to 17-year-olds with ADHD and MDD were being treated with stimulant or antidepressant medication. The percentage of adolescents with MDD using antidepressant medications varied depending on whether adolescents, parents/carers, or both identified the presence of MDD. This highlights the importance of using information from both these informants when assessing and treating adolescent depressive disorder.

Depression and quality of life in children with sickle cell disease: the effect of social support.

BackgroundThe majority of available studies have shown that children with sickle cell disease (SCD) have a higher risk of depressive symptoms than those without. The present study aimed to: assess the prevalence of depression in a sample of children with SCD; evaluate the association between disease severity, social support and depression, and the combined and/or singular effect on health-related quality of life (HRQL) in children with SCD; and show the predictive value of social support and disease severity on depression.MethodsA total of 120 children were included in the study, 60 (group I) with SCD and 60 matched, healthy control children (group II). Depression was assessed in both groups using the Children’s Depression Inventory (CDI) and the Children’s Depression Inventory-Parent (CDI-P). Children with CDI and CDI-P scores of more than 12 were interviewed for further assessment of depression using the Diagnostic Interview Schedule for Children Version IV (DISC-IV). The Pediatric Quality of Life Inventory Version 4.0 Generic Core Scales (PedsQL 4.0) was used to assess HRQL in both groups, and social support was measured with the Child and Adolescent Social Support Scale (CASSS).ResultsEight (13%) of the 60 children with SCD had CDI and CDI-P scores of more than 12 (CDI mean score 14.50 ± 1.19, CDI-P mean score 14.13 ± 1.12), and were diagnosed as having clinical depression using the diagnostic interview DISC-IV. For group I, HRQL was poor across all PedsQL 4.0 domains in both self- and parent-reports (P < 0.001) compared with group II. A higher level of parent support was a significantly associated with decreased depressive symptoms, demonstrated by lower CDI scores. Better quality of life was shown by the associated higher total PedsQL 4.0 self-scores of children with SCD (B = −1.79, P = 0.01 and B = 1.89, P = 0.02 respectively).ConclusionsThe present study demonstrates that higher levels of parent support were significantly associated with decreased depressive symptoms and better quality of life in children with SCD. Interventions focused on increasing parent support may be an important part of treatment for depression in children with SCD.

Clinical utility of the Chinese Strengths and Weaknesses of ADHD-Symptoms and Normal-Behaviors questionnaire (SWAN) when compared with DISC-IV.

BackgroundAttention-deficit/hyperactivity disorder (ADHD) is a common and impairing child and adolescent psychiatric disorder. Early identification and prompt treatment are essential. Rating scales are commonly used by clinicians and researchers to assess ADHD children.ObjectiveIn the current study, we aimed to examine the clinical utility of the Chinese version of the Strengths and Weaknesses of ADHD Symptoms and Normal Behaviors (SWAN) questionnaire. We validated its subscale scores against the Diagnostic Interview Schedule for Children Version IV (DISC-IV) and looked into its ability to identify ADHD in a psychiatric clinic setting. We also tested age and gender effects on SWAN scores. Specific subscale cutoff scores of SWAN were subsequently determined.MethodA total of 290 children aged 6–12 years old studying in local mainstream primary schools were recruited from a clinic setting and interviewed with the parent version of DISC-IV. Their parents and teachers completed the corresponding version of SWAN.ResultsBoth parent and teacher versions of SWAN were found to have good concurrent validity with DISC-IV. It could identify ADHD well in a clinic sample. Gender-specific cutoff scores were determined. Sensitivities and specificities were found to be satisfactory. SWAN was also found to perform equally well in identifying ADHD in those with and without comorbid Autistic Spectrum Disorder.ConclusionSWAN was proven to be a useful tool to aid the assessment of ADHD in a clinic sample.

The utility of quantitative electroencephalography and Integrated Visual and Auditory Continuous Performance Test as auxiliary tools for the Attention Deficit Hyperactivity Disorder diagnosis

ObjectiveThis study investigated the clinical utility of quantitative electroencephalography (QEEG) and the Integrated Visual and Auditory Continuous Performance Test (IVA+CPT) as auxiliary tools for assessing Attention Deficit Hyperactivity Disorder (ADHD). MethodsAll of 157 subjects were assessed using the Korean version of the Diagnostic Interview Schedule for Children Version IV (DISC-IV). We measured EGG absolute power in 21 channels and conducted IVA+CPT. We analyzed QEEG according to the Hz range: delta (1–4Hz), theta (4–8Hz), slow alpha (8–10Hz), fast alpha (10–13.5Hz), and beta (13.5–30Hz). To remove artifacts, independent component analysis was conducted (ICA), and the tester confirmed the results again. ResultsAll of the IVA+CPT quotients showed significant differences between the ADHD and control groups. The ADHD group showed significantly increased delta and theta activity compared with the control group. The z-scores of theta were negatively correlated with the scores of IVA+CPT in ADHD combined type, and those of beta were positively correlated. ConclusionsIVA+CPT and QEEG significantly discriminated between ADHD and control groups. The commission error of IVA+CPT showed an accuracy of 82.1%, and the omission error of IVA+CPT showed an accuracy of 78.6%. SignificanceThe IVA+CPT and QEEG are expected to be valuable tools for aiding ADHD diagnosis accurately.

Impact of the DSM-5 Attention-Deficit/Hyperactivity Disorder Age-of-Onset Criterion in the US Adolescent Population

The present study aims to compare the prevalence and clinical correlates of DSM-IV versus DSM-5-defined attention-deficit/hyperactivity disorder (ADHD) and subtypes in a nationally representative sample of US youth based on the age-of-onset criterion. The sample includes 1,894 participants 12 to 15 years of age from cross-sectional National Health and Nutrition Examination Survey (NHANES) surveys conducted from 2001 to 2004. Data on DSM-IV and DSM-5 criteria for ADHD were derived from administration of the parental ADHD module of the National Institute of Mental Health (NIMH) Diagnostic Interview Schedule for Children, Version IV (DISC-IV). Extension of the age-of-onset criterion from 7 to 12 years led to an increase in the prevalence rate of ADHD from 7.38% (DSM-IV) to 10.84% (DSM-5). Youth with later age of onset did not differ from those with earlier age of onset in terms of severity and patterns of comorbidity. However, the group with later age of onset was more likely to be from lower income and ethnic minority families. The comparability of the clinical significance of the early and later age-of-onset groups supports the DSM-5 extension of the age-of-onset criterion in ADHD.

The validities and efficiencies of korean ADHD rating scale and korean child behavior checklist for screening children with ADHD in the community.

ObjectiveThe purpose of this study is to examine the validity of primary screening tools for attention deficit hyperactivity disorder (ADHD) in a community-based sample of children using the Korean version of the Child Behavior Checklist (K-CBCL) and the Korean version of the ADHD Rating Scale (K-ARS).MethodsA large-scale community-based study for ADHD screening was conducted in the Jeollabuk province in the Republic of Korea. In 2010-2011, we surveyed a total of 49,088 first- and fourth-grade elementary school students. All of the participants in this study were assessed by the K-ARS-Parent version (K-ARS-P) and the K-ARS-Teacher version (K-ARS-T) as the primary screening instruments. The Diagnostic Interview Schedule for Children Version IV (DISC-IV) was used for confirming the diagnosis of ADHD. DISC-IV was administered to subjects who received top 10% scores in the K-ARS-P or K-ARS-T tests.ResultsOf the 3,085 subjects who completed the DISC-IV, 1,215 were diagnosed as having ADHD. A reasonable level of sensitivity, specificity, and negative predictive value were obtained when the total K-ARS-P scores were ≥90th percentile. The positive predictive value and specificity increased significantly when the total K-ARS-P scores were ≥90th percentile, T scores were ≥60 in the attention problems of K-CBCL, and T scores were ≥63 in the total problems of K-CBCL.ConclusionThese results suggested that the K-ARS-P could effectively serve as a primary screening tool to identify elementary school children with ADHD in the community. Also, there might be some increment in the effectiveness of K-ARS-P when combined with K-CBCL-A and K-CBCL-T as a secondary screening tool.

EPA-0177 – Depression and quality of life in children with sickle cell disease: the effect of social support

Majority of the available studies have shown that children with sickle cell disease (SCD) have a higher risk of depressive symptoms To assess the prevalence of depression in a sample of children with SCD and evaluate the association between various types of social support and depression, quality of life in those children. 120 children were included in the study, 60 of them (group I) with SCD and 60 were matched healthy control children (group II). Depression was assessed in both groups using ThesChildren's Depression Inventory (CDI), The Children's Depression InNntory-Parent (CDI-P) and the Diagnostic Interview Schedule for Children version IV (DISC-IV). The Pediatric Quality of Life Inventory version 4.0 generic core scales (Peds-QL 4.0) was used to assess the health-related quality of life (HRQOL) and social support was measured with the Child and Adolescent Social Support Scale (CASSS). Eight children (13%) of the 60 children with SCD scored >12 on CDI (mean score 14.50±1.19), CDI-P (mean score 14.13±1.12) and diagnosed as having clinical depression using the diagnostic interview DISC-IV. HRQOL was poor in group I compared with group II, reflected by significantly lower mean scores in all domains of Peds-QL both in self and parent report (P>0.001). Increased levels of parent support was a significant predictor associated with decreased depressive symptoms and better quality of life in children with SCD (B= −1.79, P=0.01 and B=1.89, P=0.02 respectively). Increased parent support was significantly associated with decreased depressive symptoms and better quality of life in children with SCD, so support intervention focusing on increasing parent support may be important as a part of treatment of depression in those children.

Relationship between blood manganese levels and children's attention, cognition, behavior, and academic performance—A nationwide cross-sectional study

Manganese (Mn) is neurotoxic at high concentrations. However, Mn is an essential element that can protect against oxidative damage; thus, extremely low levels of Mn might be harmful. Our aim was to examine whether either high or low environmental Mn exposure is related to academic and attention function development among school-aged children.This cross-sectional study included 1089 children 8–11 years of age living in five representative areas in South Korea. Blood Mn, blood lead, and urine cotinine were measured. We assessed IQ with the Wechsler Abbreviated Scale of Intelligence; attention with a computerized continuous performance test called the Attention-deficit/hyperactivity disorder (ADHD) Diagnostic System (ADS), the Korean version of the Stroop Color-Word Test, the Children's Color Trails Test (CCTT), and the ADHD Rating Scale; academic functions with the Learning Disability Evaluation Scale (LDES); and emotional and behavioral problems with the Korean version of the Child Behavior Checklist (CBCL). We further assessed the presence of ADHD using a highly structured diagnostic interview, the Diagnostic Interview Schedule for Children Version IV (DISC-IV).The median blood concentration of Mn was 14.14µg/L. We observed a nonlinear association between the CCTT2 completion time and the CPT commission error (F=3.14, p=0.03 and F=4.05, p=0.01, respectively). We divided the data into three groups: lower (<8.154µg/L), and upper 5th percentile (>21.453µg/L) and middle 90th percentile to determine whether a lack or overload of Mn could cause adverse effects. After adjusting for urine cotinine, blood lead, children's IQ, and other potential confounders, the high Mn group showed lower scores in thinking (B=−0.83, p=0.006), reading (B=−0.93, p=0.004), calculations (B=−0.72, p=0.005), and LQ (B=−4.06, p=0.006) in the LDES and a higher commission error in the CPT (B=8.02, p=0.048). The low Mn group showed lower color scores in the Stroop test (B=−3.24, p=0.040).We found that excess Mn in children is associated with lower scores of thinking, reading, calculation, and LQ in the LDES and higher scores of commission error in the ADS test. In contrast, lower Mn in children is associated with lower color scores in the Stroop test. The findings of this cross-sectional study suggest that excess exposure or deficiency of Mn can cause harmful effects in children.

Prevalence of child and adolescent mental disorders in Chile: a community epidemiological study

In Latin America, there is limited research on the prevalence of mental disorders in children and adolescents. This Chilean survey is the first national representative survey in the Latin American region to examine the prevalence of diagnostic and statistical manual-IV (DSM-IV) psychiatric disorders in the region in children and adolescents. Subjects aged 4-18 were selected using a stratified multistage design. The diagnostic interview schedule for children version IV (DISC-IV) was used to obtain 12-month DSM-IV diagnoses of affective, anxiety, conduct and substance use disorders, and supplemented with questionnaires examining family risk factors, family income, and service utilization. The parent or the primary caretaker was interviewed for children, aged 4-11, using the DISC-IV; however, adolescents, aged 12-18, were directly interviewed. A sample of 1558 children and adolescents was evaluated. Using the most stringent DISC-IV impairment algorithm, the prevalence rate for any psychiatric disorders was 22.5% (19.3% for boys and 25.8% for girls). The prevalence rate was higher among the children, aged 4-11, in comparison with adolescents, aged 12-18 (27.8% and 16.5%, respectively). Less than half of the subjects in need of services sought some form of assistance. Nearly a quarter of those using services did not present with a psychiatric diagnosis in the past year. Comorbidity was found in 24.8% of those with a disorder, but only 6.3% had three or more diagnoses. The prevalence of psychiatric disorders in Chile is high among children and adolescents. This study highlights the increasing need to reevaluate mental health services provided to children and adolescents in Latin America.

A 30-Month Prospective Follow-up Study of Psychological Symptoms, Psychiatric Diagnoses, and Their Effects on Quality of Life in Children Witnessing a Single Incident of Death at School

We explored the course of trauma-related psychological symptoms and psychiatric diagnoses in 167 children who, as fourth graders, witnessed death at school and assessed the long-term effects of their symptoms on quality of life and their parents' rearing stress. 167 children were evaluated using diverse self-rating symptom scales at 2 days (T1: May 19, 2007), 2 months (T2: July 16, 2007), 6 months (T3: November 12-17, 2007), and 30 months (T4: November 16-21, 2009) after the accident. All children were interviewed with the Diagnostic Interview Schedule for Children-Version IV (DISC-IV) at T1. High-risk children were assessed with the DISC-IV at T3 and T4. Children's quality of life and parental stress were assessed in all children and parents using the Parenting Stress Index and the Child Health and Illness Profile at T4. The mean scores and prevalence of severe posttraumatic stress disorder (PTSD) and anxiety symptoms decreased significantly over time (P < .001), but depressive symptoms did not. Although the prevalence of DISC-IV-based diverse anxiety disorders decreased significantly over time, 45% of high-risk subjects evaluated with the DISC-IV met criteria for an anxiety or depressive disorder at T4. Linear and logistic regression analyses showed that depressive symptoms at 6 months predicted more severe parental stress (β = 0.51; odds ratio [OR] = 2.88), less satisfaction (β = -0.25; OR = 2.66), and lower achievement (β = -0.41; OR = 1.50) at 30 months. PTSD symptoms were not associated with parental stress or quality of life at T4. This study provides new evidence regarding the long-term course of trauma-related symptoms and diagnostic changes in children exposed to a single trauma. Children's depressive symptoms predicted lower children's quality of life and higher parental rearing stress after 2 years. Careful assessment and management of depressive symptoms can potentially reduce parental stress and improve quality of life of children.

Salud mental infanto-juvenil en Chile y brechas de atención sanitarias

Psychiatric disorders that appear during childhood or adolescence should be a public health priority. To report the results of a national representative survey in the Latin American region examining the prevalence of DSM-IV psychiatric disorders in children and adolescents. Subjects aged 4 to 18 years were selected using a stratified multistage design. The Diagnostic Interview Schedule for Children Version IV (DISC-IV) was used to obtain 12-month DSM-IV diagnoses, and was supplemented with questionnaires examining family risk factors, socioeconomic status and service use. A sample of 1558 children and adolescents (51% males) was evaluated. Fifty three percent of the sample were children aged 4 to 11 years and the rest were adolescents aged 12 to 18 years. The prevalence rate for any psychiatric disorder without impairment was 38.3% (33.5% for boys and 43.3% for girls). The prevalence rate was higher among children as compared to adolescents (42.9% and 33.2%, respectively). A third of participants receiving a diagnosis sought some form of assistance. Nearly a quarter of those using services, did not have a psychiatric diagnosis in the past year. Comorbidity was found in 27% of those with a disorder, but only 7% had three or more diagnoses. The prevalence of psychiatric disorders in Chile is high among children and adolescents. This study highlights the increasing need to re-evaluate mental health services provided to children and adolescents in our country.

The mental health needs of incarcerated youth in British Columbia, Canada

The purpose of the study was to identify the current prevalence of mental disorders and mental health needs among incarcerated male and female youths in Canada, and to present these data in the context of rates found in other jurisdictions. One hundred forty male and 65 female incarcerated young offenders in British Columbia were screened with the Massachusetts Youth Screening Instrument Version 2 (MAYSI-2); provisional psychiatric diagnoses were assessed with the Diagnostic Interview Schedule for Children Version IV (DISC-IV); abuse history and aggressive symptoms of Conduct Disorder (CD) were coded from file information. Nearly all youths (91.9% of males and 100% of females) met the criteria for at least one mental disorder. Substance abuse and dependence disorders were highly prevalent (85.5% of males and 100% of females). Aggressive forms of CD were common (72.9% of males and 84.3% of females), as were exposure to physical abuse (60.8% of males and 54.3% of females) and sexual abuse (21.2% of males and 42.4% of females). Female youths had significantly higher odds of presenting with: (1) substance abuse/dependence disorders; (2) current suicide ideation; (3) sexual abuse; (4) PTSD; (5) symptoms of depression and anxiety; (6) Oppositional Defiant Disorder; and (7) multiple mental disorder diagnoses. Male youths had significantly higher odds of presenting with aggressive symptoms of CD. Overall, rates of mental disorder among this sample of serious and violent young offenders were higher than rates previously reported for incarcerated youths — both in Canada and in other jurisdictions.

Are Teacher Ratings and Parent Ratings Differently Associated with Children's Intelligence and Cognitive Performance?

ObjectiveThe present study investigated whether teacher ratings and parent ratings of inattentive or hyperactive/impulsive symptoms were differently associated with intelligence or cognitive performance in Korean children.MethodsSix hundred sixty-seven children were recruited from nine schools in five Korean cities. The teachers and parents of 580 of these children (9.0±0.7 years old, 333 boys and 306 girls) completed the Korean version of the Attention-Deficit/Hyperactivity Disorder Rating Scales (K-ARS), and the children performed the abbreviated form of the Korean Educational Development Institute-Wechsler Intelligence Scales (KEDI-WISC) and a neurocognitive battery consisting of the continuous performance test, the Children's Color Trails Test, and the Stroop Color-Word Test. Diagnosis of full-syndrome and subthreshold attention-deficit/hyperactivity disorder (ADHD) were based on the Diagnostic Interview Schedule for Children Version-IV (DISC-IV).ResultsThe level of agreement between teacher and parent ratings was low (r=0.21-0.26) in children with full-syndrome and subthreshold ADHD and low to moderate (r=0.31-0.41) in the normative sample. Teacher-rated ARS showed significant correlations with most sub-scores of KEDI-WISC and the neurocognitive battery both in the normative sample (r=-0.50-0.37) and in children with full-syndrome and subthreshold ADHD (r=-0.26-0.29). Correlations between parent-rated ARS and cognitive tests were lower and were found in fewer subscales of tests.ConclusionThese results suggest the importance of considering the teacher's report of a child's school functioning during the assessment of ADHD.

Prevalence of DSM-IV Disorder in a Representative, Healthy Birth Cohort at School Entry: Sociodemographic Risks and Social Adaptation

The aims of this paper are as follows: to present past-year prevalence data for DSM-IV disorders in the early elementary school years; to examine the impact of impairment criteria on prevalence estimates; to examine the relation of sociodemographic and psychosocial risk factors to disorders; and to explore associations between "internalizing" and "externalizing" disorders and social competence and family burden as further validation of the impairing nature of these disorders. As part of a longitudinal representative population study of children born healthy between July 1995 and September 1997 in the New Haven-Meriden Standard Metropolitan Statistical Area of the 1990 Census (n = 1,329), parents of a subsample enriched for child psychopathology (n = 442; 77.6% response rate, 69.5% of eligible sample) were interviewed in the child's kindergarten or first-grade year with the Diagnostic Interview Schedule for Children, Version IV (DISC-IV). Parents were surveyed about sociodemographic and psychosocial characteristics, and both parents and teachers were surveyed about social competence. Approximately one in five (21.6 %) children met criteria for psychiatric disorder(s) with impairment. Sociodemographic and psychosocial correlates included persistent poverty beginning in early childhood, limited parental education, low family expressiveness, stressful life events, and violence exposure. Finally, diagnostic status was significantly associated with poorer social competence and family burden. That approximately one in five children evidenced a psychiatric disorder with impairment during the transition to formal schooling highlights the importance of integrating psychiatric epidemiological and developmental approaches to inform conversations about school readiness and intervention planning.

The Brief Child and Family Phone Interview (BCFPI): 2. Usefulness in screening for child and adolescent psychopatholog

This study examines the use of the Brief Child and Family Phone Interview (BCFPI) to screen for childhood psychiatric disorder based on Diagnostic Interview Schedule for Children Version IV (DISC-IV) classifications of attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder (CD), separation anxiety (SAD), generalized anxiety (GAD) and major depression (MDD). Data for analysis come from a sample of 399 children and adolescents aged 5-17 years old referred to child mental health outpatient services in three Ontario cities. Mothers were administered the BCFPI on three occasions: baseline, 2 and 13 months; and the DISC-IV on two occasions: 1 and 12 months. Based on kappa, test-retest reliability for disorders classified by the BCFPI exceeded .50 for all conditions except MDD (.45). In receiver operating characteristic (ROC) analysis, area-under-the-curve (AUC) estimates for BCFPI scale score associations with DISC-IV classifications of disorder exceeded .80 for CD, ODD, ADHD and SAD; and were lower for GAD (.76) and MDD (.75). In stratified analyses, there were no statistically significant differences in AUC estimates for boys versus girls and 5 to 11 versus 12 to 17-year-olds. Classifications of childhood disorder derived from the BCFPI provided a reasonable approximation to disorders classified by the DISC-IV administered by lay interviewers.

Perinatal and Familial Risk Factors Are Associated with Full Syndrome and Subthreshold Attention-Deficit Hyperactivity Disorder in a Korean Community Sample

ObjectiveThe objective of this study was to examine the effect of perinatal and familial risk factors on full syndrome and subthreshold attention-deficit/hyperactivity disorder (ADHD) among Korean children and adolescents.MethodsA sample of 2,673 students was randomly selected from 19 representative schools in Seoul, Korea. The parents of the students completed the Diagnostic Interview Schedule for Children-version IV (DISC-IV), as well as questionnaires on perinatal and familial risk factors.ResultsMaternal stress and alcohol use during pregnancy, parental marital discord, parental separation or divorce, changes in primary caregivers, and notbreastfeeding were significantly associated with full syndrome ADHD; however, maternal stress during pregnancy was the only variable that differentiated subthreshold ADHD from non-ADHD.ConclusionOur results provide evidence the perinatal and familial risk factors contribute to the development of ADHD in Korea children and adolescents, and suggest that these perinatal and familial risk factors are more closely related to full syndrome than to subthreshold ADHD.