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Structured diagnostic interviews and clinicians' discharge diagnoses in hospitalized adolescents
E T Aronen1, G G Noam, S R Weinstein
1Helsinki University.
Objective:
In this study Diagnostic Interview Schedule for Children (DISC-C) and clinicians' discharge diagnoses, as well as clinicians' admission and discharge diagnoses were compared.
Method:
Patients (N = 163) ages 12 to 16 were interviewed with the DISC-C during the first month of admission. The frequencies for different diagnoses by DISC-C and by clinicians at the time of admission and discharge were tabulated. Kappa coefficients were obtained from cross-tabulated frequencies of DISC and clinicians' discharge diagnoses.
Results:
At discharge, the clinicians diagnosed more patients with multiple diagnoses and also diagnosed more patients with conduct and substance abuse disorders, dysthymia, and psychosis than they did at admission. The DISC-C diagnosed more patients with these disorders, except with psychosis, than did clinicians at either admission or discharge. The agreement between the clinicians' discharge and DISC-C diagnoses remained low across the diagnostic categories.
Conclusions:
These findings support the view that the comprehensiveness and structure of the DISC-C can contribute to the sensitivity of the diagnostic process.