Diagnostic agreement between clinicians and the Diagnostic Interview for Children and Adolescents--DICA-R--in an outpatient sample.

The paper examines the diagnostic agreement between clinicians and the Diagnostic Interview for Children and Adolescents. One hundred and thirty-seven outpatients-children and adolescents, and their parents-were diagnosed independently following DSM-III-R criteria by clinicians and by the DICA-R. The diagnostic concordance between clinicians and DICA-R ranged from low to moderate in the majority of the categories. The only exception was Conduct Disorder. Differences depending on the informant and the quality of the information (cognitive vs. observable) were observed. Combining the information from the child/adolescent and their parents ameliorates the concordance. The reasons for the scanty agreement found could be due to the fact that clinicians and structured interviews differ in what they evaluate (conditions on which they focus), how they evaluate (strictness in the criteria application, use of different informants and different information etc.), and when they evaluate (present condition vs. lifespan). After analysing the pros and cons of both, the use of structured interviews is advisable for research purposes. There is a clear need for a variety of informants, and the combination of information from different sources is recommended, depending on the age of the children and the type of disorder.