Parent and child contributions to diagnosis of mental disorder: Are both informants always necessary?

Peter S. Jensen, Maritza Rubio-Stipec, Glorisa Canino, Hector R. Bird, Mina K. Dulcan, Mary E. Schwab-Stone, Benjamin B. Lahey

Research output: Contribution to journalArticle

438 Scopus citations

Abstract

Objective: To examine the unique cases contributed by parent and child informants to diagnostic classification, with the goal of identifying those diagnoses for which either or both informants are needed. Method: The authors examined survey data from the Methods for the Epidemiology of Child and Adolescent Mental DiSorders (MECA) Study, a 4-community epidemiology survey of 9- to 17-year-old children and their parents. Parent-child dyads (1,285 pairs)were independently interviewed by lay persons with the Diagnostic Interview Schedule for Children; a subset of these pairs (n = 247) were also interviewed by clinicians. Agreement between parents and children was examined with respect to levels of impairment, need for/use of services, and clinicians' diagnoses. Results: Parents and children rarely agreed on the presence of diagnostic conditions, regardless of diagnostic type. Nonetheless, most Child-only-and parent-only-identified diagnoses were similarly related to impairment and clinical validation, with 2 exceptions: child-only-identified attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). Conclusion: Overall findings suggest that most 'discrepant' diagnoses (those reported by one but not the other informant) reflect meaningful clinical conditions. In some instances, however, diagnoses reported by one but not the other informant should be treated with caution, as they may not reflect the full diagnostic condition (e.g., possibly child-only-identified ADRD or ODD). Further research is needed to determine the salience of child-only- or parent-only-reported cases.

Original languageEnglish (US)
Pages (from-to)1569-1579
Number of pages11
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume38
Issue number12
DOIs
StatePublished - Jan 1 1999

Keywords

  • Child psychopathology
  • Diagnostic Interview Schedule for Children
  • Informants

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health

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