Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK.
Department of Psychology, University of Bath, UK.
Clin Child Psychol Psychiatry. 2021 Apr;26(2):367-380. doi: 10.1177/1359104521994880. Epub 2021 Feb 15.
One in three adolescents with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) have mental health problems. Multi-informant perspectives are key to psychological assessment. Understanding parent-child agreement is crucial to accurate diagnosis, particularly where severe fatigue limits self-report.
Agreement on the revised children's anxiety and depression scale (RCADs) was assessed between parents and children with CFS/ME ( = 93) using Bland-Altman plots, cross tabulations and regression analyses.
Diagnostic thresholds were met more frequently based on child-report. Parent- and child-report had similar sensitivity and specificity on RCADS compared to gold-standard diagnostic interviews. Regression analysis found similar accuracy between both reports. For anxiety diagnoses, odds ratio (OR) for child-report was 1.10 (CI = 1.06-1.14), and 1.10 (CI = 1.05-1.14) for parent-report. For depression, OR for child report was 1.26 (CI = 1.11-1.43), while for parent-report is was 1.25 (CI = 1.10-1.41). For total score, OR for child-report was 1.10 (CI = 1.05-1.13) while OR for parent-report was 1.09 (CI = 1.05-1.13).
Reasonable agreement was observed between parent- and child-report of mental health symptoms in paediatric CFS/ME. While parent-report can facilitate psychological evaluation in CFS/ME, this is not a substitute for a child's own report.
每三个慢性疲劳综合征/肌痛性脑脊髓炎（CFS/ME）青少年中就有一个存在心理健康问题。多信息源观点对于心理评估至关重要。了解父母与子女的一致性对于准确诊断至关重要，特别是在严重疲劳限制自我报告的情况下。
使用 Bland-Altman 图、交叉表和回归分析评估 93 名 CFS/ME 儿童及其父母对修订后的儿童焦虑和抑郁量表（RCADs）的一致性。
基于儿童报告，更频繁地达到诊断阈值。与金标准诊断访谈相比，RCADS 儿童报告和父母报告在焦虑和抑郁方面均具有相似的敏感性和特异性。回归分析发现两种报告的准确性相似。对于焦虑症诊断，儿童报告的优势比（OR）为 1.10（CI = 1.06-1.14），父母报告为 1.10（CI = 1.05-1.14）。对于抑郁症，儿童报告的 OR 为 1.26（CI = 1.11-1.43），而父母报告的 OR 为 1.25（CI = 1.10-1.41）。对于总分，儿童报告的 OR 为 1.10（CI = 1.05-1.13），而父母报告的 OR 为 1.09（CI = 1.05-1.13）。
在儿科 CFS/ME 中观察到父母和子女对心理健康症状的报告之间存在合理的一致性。虽然父母报告可以促进 CFS/ME 的心理评估，但这不能替代儿童自己的报告。
