Schedule for affective disorders and schizophrenia for school-age children (K-SADS-PL) for the assessment of preschool children–a preliminary psychometric study

Boris Birmaher, Mary Ehmann, David A Axelson, Benjamin I Goldstein, Kelly Monk, Catherine Kalas, David Kupfer, Mary K Gill, Ellen Leibenluft, Jeffrey Bridge, Amanda Guyer, Helen L Egger, and David A Brent (2009).  J Psychiatr Res, 43(7):680-6.

OBJECTIVE: To assess the psychometrics of the schedule for affective disorders and schizophrenia for school-age children present and lifetime version (K-SADS-PL) in diagnosing DSM-IV psychiatric disorders and subsyndromal symptomatology in preschool children. METHOD: Parents were interviewed about their children using the K-SADS-PL, and they completed the early childhood inventory-4 (ECI-4) and child behavior checklist for ages 1(1/2)-5 years (CBCL).Discriminant, divergent, and convergent validity of the K-SADS-PL were evaluatedin 204 offspring ages 2-5 years old of parents from an ongoing study. Inter-rater reliability as well as predictive validity of intake diagnoses at second assessment approximately two years after intake were evaluated. Fourteen children were also assessed by the preschool age psychiatric assessment (PAPA). RESULTS: Children who were diagnosed with oppositional defiant disorder, attention deficit hyperactivity disorder, anxiety, mood, or elimination disorders had significantly higher scores on the ECI-4 than children without these disorders. Significant correlations were found for all convergent CBCL scales. Divergent validity was acceptable for emotional disorders. Inter-rater kappa coefficients for all diagnoses were good. Above noted results were similar for children with at leastone positive K-SADS-PL key screen symptom. A significantly higher percentage of children with an intake diagnosis had a diagnosis approximately two years after intake compared to those without an intake disorder. Overall, there was consistency between the PAPA and the K-SADS-PL. CONCLUSIONS: Pending further testing, the K-SADS-PL may prove useful for the assessment of psychopathology inpreschoolers.

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