Structured diagnostic interviews and clinicians' discharge diagnoses in hospitalized adolescents.

OBJECTIVE

In this study Diagnostic Interview Schedule for Children (DISC-C) and clinicians' discharge diagnoses, as well as clinicians' admission and discharge diagnoses were compared.

METHOD: Patients (N = 163) ages 12 to 16 were interviewed with the DISC-C during the first month of admission. The frequencies for different diagnoses by DISC-C and by clinicians at the time of admission and discharge were tabulated. Kappa coefficients were obtained from cross-tabulated frequencies of DISC and clinicians' discharge diagnoses.

RESULTS

At discharge, the clinicians diagnosed more patients with multiple diagnoses and also diagnosed more patients with conduct and substance abuse disorders, dysthymia, and psychosis than they did at admission. The DISC-C diagnosed more patients with these disorders, except with psychosis, than did clinicians at either admission or discharge. The agreement between the clinicians' discharge and DISC-C diagnoses remained low across the diagnostic categories.

CONCLUSIONS

These findings support the view that the comprehensiveness and structure of the DISC-C can contribute to the sensitivity of the diagnostic process.