Abstract
In a prospective Multi-Centre research study involving four British Adolescent Psychiatry Inpatient Units, all 276 adolescent admissions were diagnosed using both ICD-9 and DSM-III. Ratings of diagnostic confidence for each diagnostic group varied considerably. Clinicians recorded high levels of confidence in the diagnosis of both Schizophrenia and Anorexia nervosa, while considerably lower scores were noted for Adjustment Disorders (ICD-9 3-digit code 309.), and for Emotional Disorders (ICD-9 3-digit code 313.).
Exact concordance in diagnoses made for each case using both ICD-9 and DSM-III occurred in 72% of the entire cohort. The dissimilar concordance rates comparing ICD-9 and DSM-III diagnoses for the same patient admissions suggest differences in validity measures, such as face validity and content validity, in the reliability of diagnostic criteria between similarly named disorders across the two systems, and in the clinician's training and attitude to diagnosis. With the recent introduction of DSM-IV following upon ICD-10, further comparative studies are needed to examine both reliability and validity issues into diagnosis and classification in child and adolescent psychiatry.
Similar content being viewed by others
References
American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders. APA, Washington, D.C.
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders. APA, Washington, D.C.
Blanz B, Schmidt MH (1986) (Child and Adolescent psychiatric classification in an unselected sample — a comparison of MAS and DSM-III). Zeitschrift fur Kinder and Jugendpsychiatrie 14:296–307 (In German)
Blanz B, Schmidt, MH, Niemeyer J, Amorosa H (1990) Phenomenal and operationalized classification of psychiatric disorders in children and adolescents with ICD-9 and ICD-10, on the basis of a field study. Pharmacopsychiatry 23:177–182 (Supplement)
Cantwell DP, Baker L (1988) Issues in the classification of child and adolescent psychopathology. Journal of the American Academy of Child and Adolescent Psychiatry 27:521–533
Cantwell DP, Russell AT, Mattison RE, Will L (1979) A Comparison of DSMIII and DSM-II in the diagnosis of childhood psychiatric disorders. 1. Agreement with expected diagnoses. Archives of General Psychiatry 36: 1208–1216
Mattison R, Cantwell DP, Russell AT, Will L (1979) A Comparison of DSMII and DSM-III in the diagnosis of childhood and adolescent psychiatric disorders. Archives of General Psychiatry 36:1217–1222
Mezzich AC, Mezzich JE (1985) Perceived suitability and usefulness of DSM-III vs. DSM-II in child psychopathology. Journal of the American Academy of Child Psychiatry 24: 281–285
NHS Executive - Information Management Group (1995) Read Codes and the terms projects: a brief guide. UK February 1995
Pedreira Massa JL, Rincon Palomino F (1989) (Classification of psychiatric disorders in children: a comparison of the most frequent systems). Actas LusoEspanolas de Neurologia, Psiquiatria Y Ciencias Afines, 17:407–416. (In Spanish)
Prendergast M, Taylor E, Rapoport JL, Bartko J, Donnelly M, Zametkin A, Ahearn MB, Durm G, Wieselberg HM (1988) The Diagnosis of Childhood Hyperactivity: A U. S. — U.K Cross National Study of DSM-III and ICD-9. Journal of Child Psychology and Psychiatry 29:289–300
Rothery DJ, Wrate RM, McCabe RJR, Aspin J, Bryce G (1995) Treatment goal-planning: outcome findings of a British prospective multi-centre study of adolescent in-patient units. European Child and Adolescent Psychiatry 4:209–221
Rutter M (1989) Child psychiatric disorders in ICD-10. Journal of Child Psychology and Psychiatry 30:499–513
Rutter M, Gould M (1985) Classification. In M Rutter and L Hersov (Eds) Child and Adolescent Psychiatry: Modern Approaches. Second Edition (pp. 304–321). Blackwell Scientific, Oxford
Schwab-Stone M, Towbin KE, Tarnoff GM (1991) Systems of Classification: ICD-10, DSM-III-R, and DSM-IV. In M Lewis (Ed) Child and Adolescent Psychiatry. Williams and Williams, Baltimore, pp 422–434
Steinhausen H-Ch, Erdin A (1991) A Comparison of ICD-9 and ICD-10 diagnoses of child and adolescent psychiatric disorders. Journal of Child Psychology and Psychiatry 32:909–920
Werry JS (1985) ICD-9 and DSM-III Classification for the Clinician. Journal of Child Psychology and Psychiatry 26:1–6
Werry JS (1992) Child psychiatric disorders: are they classifable? British Journal of Psychiatry 161:472–480
World Health Organization (1980) International Classification of Diseases and Disorders (ICD-9). Author, Geneva
World Health Organization (1992) The ICD-10 Classification of Mental and Behavioural Disorders. Clinical Descriptions and Guidelines. Author, Geneva
Wrate RM, Rothery DJ, McCabe RJR, Aspin J, Bryce G (1994) A Prospective Multi-centre Study of Admissions to Adolescent In-patient Units. Journal of Adolescence 17:221–237
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
McCabe, R.J.R., Rothery, D.J., Wrate, R.M. et al. Diagnosis in adolescent inpatients: Diagnostic confidence and comparison of diagnoses using ICD-9 and DSM-III. European Child & Adolescent Psychiatry 5, 147–154 (1996). https://doi.org/10.1007/BF00571674
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00571674