Cantwell D P, Lewinsohn P M, Rohde P, Seeley J R
University of California, Los Angeles, USA.
J Am Acad Child Adolesc Psychiatry. 1997 May;36(5):610-9. doi: 10.1097/00004583-199705000-00011.
To examine the degree of agreement between parent and adolescent report of major psychiatric disorders in the adolescent (14 to 18 years of age).
A total of 281 parent-adolescent pairs were interviewed separately regarding psychopathology in the adolescent.
The kappa values for parent-adolescent agreement on the disorders ranged from .19 for alcohol abuse/dependence to .79 for conduct disorder, with an average kappa of .42. Excellent agreement was found for conduct disorder and the core symptom of anorexia; good agreement was found for separation anxiety disorders, attention-deficit/hyperactivity disorder, oppositional defiant disorder, substance abuse/dependence, and the core symptom for bulimia; poor agreement was found for major depression, dysthymia, anxiety disorders other than separation anxiety, alcohol abuse/dependence, and the infrequent core symptoms of bipolar and obsessive-compulsive disorders. Parent-adolescent agreement was not influenced by gender, current adolescent age, parental education level, disorder onset age, or severity of disorder.
For detecting cases of adolescent psychopathology, there are clear advantages to the current consensus position that combines adolescent and parent report, especially for externalizing disorders. However, if forced to choose one informant, assessing the adolescent will result in the detection of more diagnosed cases.
探讨父母与青少年(14至18岁)对青少年主要精神障碍报告的一致程度。
共对281对父母-青少年进行了单独访谈,询问青少年的精神病理学情况。
父母与青少年在精神障碍方面的kappa值范围从酒精滥用/依赖的0.19到品行障碍的0.79,平均kappa值为0.42。品行障碍和厌食症的核心症状一致性极佳;分离焦虑症、注意力缺陷多动障碍、对立违抗障碍、物质滥用/依赖以及贪食症的核心症状一致性良好;重度抑郁症、心境恶劣、除分离焦虑症外的焦虑症、酒精滥用/依赖以及双相情感障碍和强迫症的罕见核心症状一致性较差。父母与青少年的一致性不受性别、青少年当前年龄、父母教育水平、疾病起病年龄或疾病严重程度的影响。
对于检测青少年精神病理学病例,目前将青少年报告与父母报告相结合的共识立场具有明显优势,尤其是对于外化性障碍。然而,如果被迫选择一方提供信息,评估青少年将发现更多确诊病例。