Classification of obsessive-compulsive disorder in childhood and adolescence.
OBJECTIVE
In child and adolescent psychiatry the validation of the diagnosis must be seen in the context of development. Comparing different diagnostic formulations DSM-IV and ICD-10-DCR in a clinical sample of children and adolescents suffering from obsessive-compulsive disorder (OCD) and their validation on external criteria represent such a heuristic approach.


METHODS
We investigated 61 children seen consecutively in a specialized out-patient clinic for OCD. All of them were assessed by the International Diagnostic Checklists (IDCL). Diagnosis and diagnostic certainty were validated regarding age, age of onset and duration of illness.


RESULTS
The agreement between the two diagnostic systems was low. The diagnostic stability of ICD-10-DCR was highly dependent on age, whereas that of the criteria DSM-IV did not depend on age and almost all subjects could be diagnosed definitely.


CONCLUSIONS
This study suggests that the DSM-IV criteria are superior to that of ICD-10-DCR for diagnosing OCD in children and younger adolescents.
Department of Neuropsychiatry of Childhood and Adolescence, University of Vienna, Medical school, General Hospital, Vienna, Austria. karl.steinberg@univie.ac.at
K
K
Steinberger
B
B
Schuch
D000293:Adolescent; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D012720:Severity of Illness Index