Psychosocial diagnosis in psychiatrically hospitalized adolescents

This study examines the relevance of a psychosocial diagnostic system developed by the World Health Organization (WHO; International Classification of Diseases [ICD] 10 axis V) for psychiatrically hospitalized inpatient adolescents and assesses the reliability of semistructured interviews for making these psychosocial diagnoses. Seventy-one consecutive patients admitted to an adolescent unit and their parents were interviewed. The semistructured interviews were derived from the criteria for each psychosocial (axis V) diagnosis. Inter-rater and test-retest reliability were measured for both child and parent interviews on a subsample of 57 and 25 subjects, respectively. Results showed high inter-rater reliability (kappa = 0.8 to 1.0). Some test-retest reliabilities were high and others were low (kappa = 0.4 to 1.0). Parent-child agreement was erratic (kappa = 0.2 to 0.7). All of the psychosocial diagnostic entities were common and relevant to our patient population. We conclude that it is possible to make reliable and relevant psychosocial diagnoses in severely ill adolescents.