Conflict of interest statement: potential conflict declared, see Acknowledgements.
Relation of symptom-induced impairment with other illness parameters in clinic-referred youth
Article first published online: 16 APR 2013
© 2013 The Authors Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.
Journal of Child Psychology and Psychiatry
Volume 54, Issue 11, pages 1198–1207, November 2013
How to Cite
Gadow, K. D., Kaat, A. J. and Lecavalier, L. (2013), Relation of symptom-induced impairment with other illness parameters in clinic-referred youth. Journal of Child Psychology and Psychiatry, 54: 1198–1207. doi: 10.1111/jcpp.12077
- Issue published online: 11 OCT 2013
- Article first published online: 16 APR 2013
- Manuscript Accepted: 7 MAR 2013
- Psychiatric disorder;
To examine the relation of caregiver ratings of psychiatric symptom-induced impairment with number and severity of symptoms and informant agreement in consecutive child psychiatry outpatient referrals.
Parents and teachers completed a broadband DSM-IV-referenced rating scale with disorder-specific impairment for 636 youth (6–18 years). Illness parameters included impairment, number and severity of symptoms, and their combination (symptom + impairment) as well as categorical (cut-off) and dimensional scoring.
Agreement between impairment and other illness parameters showed considerable variation as a function of type of parameter, disorder, and informant, but to lesser extent age and gender. Many youth who met impairment cut-off for specific disorders did not meet symptom cut-off. Conversely, most youth who met symptom cut-off were impaired. Symptom cut-off evidenced greater convergence with impairment cut-off than combined symptom + impairment cut-offs. Severity of impairment was moderately to highly correlated with number and severity of symptoms. Parents' and teachers' ratings indicated little disorder-specific agreement about youth who met impairment cut-off, symptom cut-off, or combined symptom + impairment cut-off. Therefore, sole reliance on one informant greatly underestimates the pervasiveness of impairment.
Findings are consistent with the notion that each illness parameter represents a unique conceptual construct, which has important clinical and research implications.