Equivalence of psychiatric structured interviews and symptom checklists in predicting health-related quality of life in children with chronic physical illness.

PURPOSE

We estimated agreement in classifying psychiatric disorders using a structured interview and symptom checklist, examined associations between psychiatric disorder and health-related quality of life (HRQL) in children with chronic physical illness, and investigated if the instruments were statistically equivalent in predicting HRQL.

METHODS

We analyzed data from children aged 4-16 years diagnosed with a chronic physical illness. Parents and children completed the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID; interview), and Emotional Behavioural Scales (EBS; checklist). Two approaches classified psychiatric disorder for the EBS: 1-thresholds based on prevalence (b-EBS); 2-T scores ≥ 70 (t-EBS). Health-related quality of life was measured using the KIDSCREEN-27. Instrument and informant agreement was estimated with kappa (κ). Regression models examined associations between psychiatric disorder at baseline and 24-month HRQL. The method of variance estimates recovery was used to determine whether the instruments were statistically equivalent.

RESULTS

Agreement for any psychiatric disorder between the parent-reported MINI-KID and b-EBS was considered substantial (κ = 0.61), but moderate with the t-EBS (κ = 0.51). Fair agreement was found for child reports (κ = 0.28 and κ = 0.29, respectively). Parent-child agreement across instruments was low. No associations between psychiatric disorder measured by the MINI-KID vs. the b-EBS or t-EBS on child HRQL were significantly different for either informant.

CONCLUSION

Agreement between instruments and informants was consistent with previous reports in other samples. Associations between psychiatric disorder and HRQL were not significantly different between the MINI-KID and EBS. Symptom checklists offer a practical opportunity to screen and monitor psychiatric disorder in children with physical illness.