Abstract
The development and well-being assessment (DAWBA) has been used in various epidemiological studies, whereas the clinical value of the instrument needs support from further studies. In particular, it is important to document how the use of the DAWBA influences clinical decision-making. The present study employed the DAWBA in a consecutive series of 270 new referrals to a large public child and adolescent psychiatric service in Zurich, Switzerland. ICD-10 based diagnoses were obtained from clinicians for all patients and reliability of DAWBA expert raters was calculated. The DAWBA diagnoses were randomly disclosed (n = 144) or not disclosed (n = 126) before clinical decision-making. The reliability of DAWBA expert diagnoses was very satisfactory and the agreement under the disclosed versus the non-disclosed condition amounted to 77 versus 68 % for internalizing disorders and to 63 versus 71 % for externalizing disorders. The increment in agreement due to disclosure of the DAWBA diagnosis was significant for internalizing disorders. Access to DAWBA information was more likely to prompt clinicians to add an extra diagnosis. Professional background and degree of clinical experience did not affect diagnostic agreement. Overall, diagnostic agreements between DAWBA expert diagnoses and clinical diagnoses were in the fair to moderate range and comparable to previous studies with other structured diagnostic interviews. The inclusion of the DAWBA into the clinical assessment process had an impact on diagnostic decision-making regarding internalizing disorders but not regarding externalizing disorders.
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References
Alyahri A, Goodman R (2006) The validation of the Arabic SDQ and DAWBA. East Mediterr Health J 12:S138–S146
Angold A, Erkanli A, Copeland W, Goodman R, Fisher PW, Costello EJ (2012) Psychiatric diagnostic interviews for children and adolescents: a comparative study. J Am Acad Child Adolesc Psychiatry 51:506–517
Basco RM, Bostic JQ, Davies D, Rush AJ, Witte B, Hendrickse W, Barnett V (2000) Methods to improve diagnostic accuracy in a community mental health setting. Am J Psychiatry 157:1599–1605
Benjamini Y, Hochberg Y (1995) Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Statist Soc Series B 57:289–300
Duffy A, Doucette S, Lewitzka U, Alda M, Hajek T, Grof P (2011) Findings from bipolar offspring studies: methodology matters. Early Interv Psychiatry 5:181–191
Fleitlich-Bilyk B, Goodman R (2004) Prevalence of child and adolescent psychiatric disorders in southeast Brazil. J Am Acad Child Adolesc Psychiatry 43:727–734
Ford T, Goodman R, Meltzer H (2003) The British Child and Adolescent Mental Health Survey 1999: the prevalence of DSM-IV disorders. J Am Acad Child Adolesc Psychiatry 42:1203–1211
Garb HN (2005) Clinical judgment and decision making. Annu Rev Clin Psychol 1:67–89
Garb HN (1998) Studying the clinician: judgment research and psychological assessment. American Psychological Association, Washington
Goodman A, Heiervang E, Collishaw S, Goodman R (2011) The ‘DAWBA bands’ as an ordered-categorical measure of child mental health: description and validation in British and Norwegian samples. Soc Psychiatry Psychiatr Epidemiol 46:521–532
Goodman R (2001) Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry 40:1337–1345
Goodman R (1997) The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry 38:581–586
Goodman R, Ford T, Richards H, Gatward R, Meltzer H (2000) The development and well-being assessment: description and initial validation of an integrated assessment of child and adolescent psychopathology. J Child Psychol Psychiatry 41:645–655
Goodman R, Slobodskaya H, Knyazev G (2005) Russian child mental health—a cross-sectional study of prevalence and risk factors. Eur Child Adolesc Psychiatry 14:28–33
Heiervang E, Stormark KM, Lundervold AJ, Heimann M, Goodman R, Posserud MB, Ullebo AK, Plessen KJ, Bjelland I, Lie SA, Gillberg C (2007) Psychiatric disorders in Norwegian 8- to 10-year-olds: an epidemiological survey of prevalence, risk factors, and service use. J Am Acad Child Adolesc Psychiatry 46:438–447
Jensen-Doss A, Hawley KM (2010) Understanding barriers to evidence-based assessment: clinician attitudes toward standardized assessment tools. J Clin Child Adolesc Psychol 39:885–896
Jensen-Doss A, Weisz JR (2008) Diagnostic agreement predicts treatment process and outcomes in youth mental health clinics. J Consult Clin Psychol 76:711–722
Jensen AL, Weisz JR (2002) Assessing match and mismatch between practitioner-generated and standardized interview-generated diagnoses for clinic-referred children and adolescents. J Consult Clin Psychol 70:158–168
Jewell J, Handwerk M, Almquist J, Lucas C (2004) Comparing the validity of clinician-generated diagnosis of conduct disorder to the diagnostic interview schedule for children. J Clin Child Adolesc Psychol 33:536–546
Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174
Martin AM, Fishman R, Baxter L, Ford T (2010) Practitioners’ attitudes towards the use of standardized diagnostic assessment in routine practice: a qualitative study in two child and adolescent mental health services. Clin Child Psychol Psychiatry 16:407–420
Meltzer H, Gatward R, Goodman R, Ford T (2000) The mental health of children and adolescents in Great Britain. The Stationery Office, London
Meltzer H, Lader D, Corbin T, Goodman R, Ford T (2004) The mental health of young people looked after by authorities in Scotland. The Stationery Office, Edinburgh
Mullick MS, Goodman R (2005) The prevalence of psychiatric disorders among 5–10 year olds in rural, urban and slum areas in Bangladesh: an exploratory study. Soc Psychiatry Psychiatr Epidemiol 40:663–671
Potts MK, Burnam MA, Wells KB (1991) Gender differences in depression detection: a comparison of clinician diagnosis and standardized assessment. Psychol Assess J Consult Clin Psychol 3:609–615
Rettew D, Doyle Lynch A, Achenbach TM, Dumenci L, Ivanova MY (2009) Meta-analyses agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews. Int J Methods Psychiatr Res 18:169–184
Steinhausen HC, Erdin A (1991) The inter-rater reliability of child and adolescent psychiatric disorders in the ICD-10. J Child Psychol Psychiatry 32:921–928
Steinhausen HC, Metzke CW, Meier M, Kannenberg R (1998) Prevalence of child and adolescent psychiatric disorders: the Zurich Epidemiological Study. Acta Psychiatr Scand 98:262–271
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RG is the owner of Youthinmind, which provides no-cost and low-cost software and web sites related to the SDQ and DAWBA.
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M. Aebi and C. Kuhn contributed equally to this manuscript.
Trial register name: The utility of standardized pre-clinical assessment based on the development and well-being assessment (DAWBA) in a child and adolescent mental health service, registration identification number: ISRCTN19935149, register-url: http://www.controlled-trials.com/ISRCTN19935149/DAWBA
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Aebi, M., Kuhn, C., Metzke, C.W. et al. The use of the development and well-being assessment (DAWBA) in clinical practice: a randomized trial. Eur Child Adolesc Psychiatry 21, 559–567 (2012). https://doi.org/10.1007/s00787-012-0293-6
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DOI: https://doi.org/10.1007/s00787-012-0293-6