The interrater reliability of DSM III in children

A total of 195 admissions to a child psychiatric inpatient unit were diagnosed independently by two to four clinicians on the basis of case presentations at the first ward-round after admission. The DSM III as a whole and the major categories were of high or acceptable reliability, though a few were clearly unreliable. The results are generally consistent with other studies. Unlike other studies, the subcategories were examined and found to vary widely in reliability both as a whole across the system and within parent major categories, throwing considerable doubt upon their utility. The results indicate the need both for improved diagnostic data-gathering techniques in child psychiatry and for more better-designed studies of reliability and, most necessarily, of validity.