Validation of the diagnoses of panic disorder and phobic disorders in the US National Comorbidity Survey Replication Adolescent (NCS-A) Supplement

School of Education, Boston University, Boston, MA, USA.
International journal of methods in psychiatric research 06/2011; 20(2):105-15. DOI: 10.1002/mpr.336
Source: PubMed


Validity of the adolescent version of the World Health Organization Composite International Diagnostic Interview (CIDI) Version 3.0, a fully-structured research diagnostic interview designed to be used by trained lay interviewers, is assessed in comparison to independent clinical diagnoses based on the Schedule for Affective Disorders and Schizophrenia for School-age Children (K-SADS). This assessment is carried out in the clinical reappraisal sub-sample (n = 347) of the US National Comorbidity Survey Adolescent (NCS-A) supplement, a large (n = 10,148) community epidemiological survey of the prevalence and correlates of adolescent mental disorders in the United States. The diagnoses considered are panic disorder and phobic disorders (social phobia, specific phobia, agoraphobia). CIDI diagnoses are found to have good concordance with K-SADS diagnoses [area under the receiver operating characteristic curve (AUC) = 0.81-0.94], although the CIDI diagnoses are consistency somewhat higher than the K-SADS diagnoses. Data are also presented on criterion-level concordance in an effort to pinpoint CIDI question series that might be improved in future modifications of the instrument. Finally, data are presented on the factor structure of the fears associated with social phobia, the only disorder in this series where substantial controversy exists about disorder subtypes.

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Available from: Alan M Zaslavsky, Oct 05, 2015
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    ABSTRACT: Specific phobia is among the most common disorders in the general adolescent population, but also among the least studied. The objectives of this study were to estimate the prevalence of specific fears among adolescents, the proportion of those with fears who meet criteria for specific phobia, and the proportion who recognize their fears as excessive and to identify comorbidity with other disorders and factors associated with severity and treatment. 3,005 youth aged 12 to 17 years participated in the Mexican Adolescent Mental Health Survey, a stratified multistage probability sample representative of adolescents living in Mexico City in 2005. Fears, specific phobia, and 20 other DSM-IV psychiatric disorders were evaluated with the adolescent computerized version of the World Mental Health Composite International Diagnostic Interview, administered by trained lay interviewers in the participants' homes. Descriptive, logistic regression, and discrete-time survival analyses were employed. Most adolescents reported at least 1 fear (76.5%); 36.5% of those met lifetime criteria for specific phobia, and 27.3% met criteria in the prior 12 months. Blood-injection-injury and animal fears were the most common types. Females were more likely to report any fear, to have more fear types, and to meet diagnostic criteria. Increased numbers of fears were associated with increased odds of meeting specific phobia criteria and with increased impairment. Among teens with specific phobia, 71.3% recognized their fear as excessive, 9.7% to 12.3% reported severe impairment, and only 6.5% had received treatment. Severity of impairment and comorbid disorders were associated with treatment seeking. The large percentage of adolescents meeting diagnostic criteria coupled with the low proportion with serious impairment suggests that current diagnostic thresholds may be too low or not developmentally sensitive. Future research should address the nature of impairment for adolescents with specific phobia. Early detection and timely treatment are important given that specific phobia is persistent and highly comorbid and that few individuals seek treatment.
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