Validación de la entrevista diagnóstica estructurada DISC-IV para la identificación de trastornos psiquiátricos en niños y adolescentes en Chile

Abstract

Introduction: In Chile there are scarce validated instruments in order to perform categorical psychiatric diagnosis both in children and adolescents. DISC-IV Spanish version validation indexes are presented. Method: A convenience sample was collected from outpatient psychiatric services as well as from private medical facilities and drug-dependence outpatient centres from Concepción, Chile. Subjects of both genders between 7 and 18 years of age, with a psychiatric diagnosis were included in the study (affective disorder, anxiety, drugs abuse and dependence, and behaviour disorder). In addition 18 subjects without psychiatric disorder were selected from a secondary school. Each selected subject that agreed to participate in the study was interviewed by a clinical experienced child psychiatrist, diagnose-blinded, using DSM-IV check list, in order to decide if the subject fulfilled DSM-IV criteria. Later, to patients 12 years old or older, or to their caregiver for children younger than 12 years DISC-IV was applied by some of the previously trained lay interviewers. Quality controls of the interviews were carried out. Data were entered to SPSS file to obtain DISC-IV validation indexes. Results: 144 subjects were incorporated in the study. Cohen's Kappa indexes, a statistical measure of inter-rater agreement, varied between 0.53 for anxiety disorders, and 0.88 for substance abuse and dependence. Every group presented high specificity ranging between 0.55 and 0.83. Interviews answered by adolescents were less sensitive for TDA (0.23) and anxiety (0.40), whereas in parents, sensitivity decreases for affective disorders (0.50). Conclusion: DISC-IV is a valid instrument to be used in the research about children and adolescent mental health.