MacLeod R J, McNamee J E, Boyle M H, Offord D R, Friedrich M
Chedoke Child & Family Centre, Hamilton Health Sciences Corporation, Ontario.
Can J Psychiatry. 1999 Mar;44(2):144-50. doi: 10.1177/070674379904400204.
To compare the identification of psychiatric disorder as informed by parents versus teachers in children aged 6-11 years and parents versus adolescents in youth aged 12-16 years in clinic versus community samples.
Study data come from parallel surveys in Hamilton, Ontario, of children aged 6-16 years. The surveys included consecutive referrals (N = 1150) between 1989 and 1991 to the region's 2 agencies providing outpatient child mental health services. Also, a simple random sample (N = 1689) was used, drawn in 1989 from students attending public schools. Conduct disorder, hyperactivity, emotional disorder, and somatization disorder were assessed by informants using the original Ontario Child Health Study scales.
The percentage of children identified with a disorder was markedly higher in the clinic sample, irrespective of the type of disorder, the age and sex of the child, and who provided the assessment. Also, there was a statistically significant differential shift between parents and teachers in the percentage of children identified with disorder. The ratio of children aged 6-11 years identified with conduct disorder or hyperactivity by parents versus teachers was higher in the clinic sample than in the community sample. Among youth aged 12-16 years, a similar pattern emerged for parents as informants versus the adolescents themselves, but it was statistically nonsignificant.
The data suggest that the relative contribution of informants to the identification of childhood psychiatric disorder varies by sample type: clinic and community. If risk factors for child disorder are influenced by contextually specific factors wedded to informants, then studies conducted in clinic versus community samples may lead to discrepant information about the determinants of psychopathology. The extent of this problem needs to be assessed by comparing the results of parallel studies conducted in clinic versus community samples.
比较在临床样本和社区样本中，6至11岁儿童的父母与教师以及12至16岁青少年的父母与青少年本人对精神障碍的识别情况。
研究数据来自安大略省汉密尔顿对6至16岁儿童的平行调查。这些调查包括1989年至1991年间该地区2家提供儿童门诊心理健康服务机构的连续转诊病例（N = 1150）。此外，1989年从公立学校的学生中抽取了一个简单随机样本（N = 1689）。使用最初的安大略儿童健康研究量表，由信息提供者对品行障碍、多动、情绪障碍和躯体化障碍进行评估。
无论障碍类型、儿童年龄和性别以及谁提供评估，临床样本中被识别出患有障碍的儿童百分比明显更高。此外，在被识别出患有障碍的儿童百分比方面，父母和教师之间存在统计学上的显著差异。在临床样本中，6至11岁儿童被父母与教师识别出患有品行障碍或多动的比例高于社区样本。在12至16岁的青少年中，父母作为信息提供者与青少年本人之间出现了类似模式，但在统计学上不显著。
数据表明，信息提供者对儿童精神障碍识别的相对贡献因样本类型（临床和社区）而异。如果儿童障碍的风险因素受与信息提供者相关的特定背景因素影响，那么在临床样本和社区样本中进行的研究可能会导致关于精神病理学决定因素的信息存在差异。需要通过比较在临床样本和社区样本中进行的平行研究结果来评估这个问题的程度。
