National comorbidity survey replication adolescent supplement (NCS-A): III. Concordance of DSM-IV/CIDI diagnoses with clinical reassessments.
OBJECTIVE
To report results of the clinical reappraisal study of lifetime DSM-IV diagnoses based on the fully structured lay-administered World Health Organization Composite International Diagnostic Interview (CIDI) Version 3.0 in the U.S. National Comorbidity Survey Replication Adolescent Supplement (NCS-A).


METHODS
Blinded clinical reappraisal interviews with a probability subsample of 347 NCS-A respondents were administered using the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS) as the gold standard. The DSM-IV/CIDI cases were oversampled, and the clinical reappraisal sample was weighted to adjust for this oversampling.


RESULTS
Good aggregate consistency was found between CIDI and K-SADS prevalence estimates, although CIDI estimates were meaningfully higher than K-SADS estimates for specific phobia (51.2%) and oppositional defiant disorder (38.7%). Estimated prevalence of any disorder, in comparison, was only slightly higher in the CIDI than K-SADS (8.3%). Strong individual-level CIDI versus K-SADS concordance was found for most diagnoses. Area under the receiver operating characteristic curve, a measure of classification accuracy not influenced by prevalence, was 0.88 for any anxiety disorder, 0.89 for any mood disorder, 0.84 for any disruptive behavior disorder, 0.94 for any substance disorder, and 0.87 for any disorder. Although area under the receiver operating characteristic curve was unacceptably low for alcohol dependence and bipolar I and II disorders, these problems were resolved by aggregation with alcohol abuse and bipolar I disorder, respectively. Logistic regression analysis documented that consideration of CIDI symptom-level data significantly improved prediction of some K-SADS diagnoses.


CONCLUSIONS
These results document that the diagnoses made in the NCS-A based on the CIDI have generally good concordance with blinded clinical diagnoses.
Kessler
Ronald C
RC
Drs. Kessler, Green, He, and Zaslavsky, Mr. Gruber, and Ms. Sampson are with the Department of Health Care Policy, Harvard Medical School; Dr. Avenevoli is with the Division of Developmental Translational Research, National Institute of Mental Health; Dr. Guyer is with the Massachusetts Mental Health Center; Dr. Kaufman is with the Department of Psychiatry, Yale Medical School; and Dr. Merikangas is with the Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health. Electronic address: kessler@hcp.med.harvard.edu.
Avenevoli
Shelli
S
Drs. Kessler, Green, He, and Zaslavsky, Mr. Gruber, and Ms. Sampson are with the Department of Health Care Policy, Harvard Medical School; Dr. Avenevoli is with the Division of Developmental Translational Research, National Institute of Mental Health; Dr. Guyer is with the Massachusetts Mental Health Center; Dr. Kaufman is with the Department of Psychiatry, Yale Medical School; and Dr. Merikangas is with the Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health.
Green
Jennifer
J
Drs. Kessler, Green, He, and Zaslavsky, Mr. Gruber, and Ms. Sampson are with the Department of Health Care Policy, Harvard Medical School; Dr. Avenevoli is with the Division of Developmental Translational Research, National Institute of Mental Health; Dr. Guyer is with the Massachusetts Mental Health Center; Dr. Kaufman is with the Department of Psychiatry, Yale Medical School; and Dr. Merikangas is with the Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health.
Gruber
Michael J
MJ
Drs. Kessler, Green, He, and Zaslavsky, Mr. Gruber, and Ms. Sampson are with the Department of Health Care Policy, Harvard Medical School; Dr. Avenevoli is with the Division of Developmental Translational Research, National Institute of Mental Health; Dr. Guyer is with the Massachusetts Mental Health Center; Dr. Kaufman is with the Department of Psychiatry, Yale Medical School; and Dr. Merikangas is with the Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health.
Guyer
Margaret
M
Drs. Kessler, Green, He, and Zaslavsky, Mr. Gruber, and Ms. Sampson are with the Department of Health Care Policy, Harvard Medical School; Dr. Avenevoli is with the Division of Developmental Translational Research, National Institute of Mental Health; Dr. Guyer is with the Massachusetts Mental Health Center; Dr. Kaufman is with the Department of Psychiatry, Yale Medical School; and Dr. Merikangas is with the Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health.
He
Yulei
Y
Drs. Kessler, Green, He, and Zaslavsky, Mr. Gruber, and Ms. Sampson are with the Department of Health Care Policy, Harvard Medical School; Dr. Avenevoli is with the Division of Developmental Translational Research, National Institute of Mental Health; Dr. Guyer is with the Massachusetts Mental Health Center; Dr. Kaufman is with the Department of Psychiatry, Yale Medical School; and Dr. Merikangas is with the Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health.
Jin
Robert
R
Drs. Kessler, Green, He, and Zaslavsky, Mr. Gruber, and Ms. Sampson are with the Department of Health Care Policy, Harvard Medical School; Dr. Avenevoli is with the Division of Developmental Translational Research, National Institute of Mental Health; Dr. Guyer is with the Massachusetts Mental Health Center; Dr. Kaufman is with the Department of Psychiatry, Yale Medical School; and Dr. Merikangas is with the Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health.
Kaufman
Joan
J
Drs. Kessler, Green, He, and Zaslavsky, Mr. Gruber, and Ms. Sampson are with the Department of Health Care Policy, Harvard Medical School; Dr. Avenevoli is with the Division of Developmental Translational Research, National Institute of Mental Health; Dr. Guyer is with the Massachusetts Mental Health Center; Dr. Kaufman is with the Department of Psychiatry, Yale Medical School; and Dr. Merikangas is with the Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health.
Sampson
Nancy A
NA
Drs. Kessler, Green, He, and Zaslavsky, Mr. Gruber, and Ms. Sampson are with the Department of Health Care Policy, Harvard Medical School; Dr. Avenevoli is with the Division of Developmental Translational Research, National Institute of Mental Health; Dr. Guyer is with the Massachusetts Mental Health Center; Dr. Kaufman is with the Department of Psychiatry, Yale Medical School; and Dr. Merikangas is with the Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health.
Zaslavsky
Alan M
AM
Drs. Kessler, Green, He, and Zaslavsky, Mr. Gruber, and Ms. Sampson are with the Department of Health Care Policy, Harvard Medical School; Dr. Avenevoli is with the Division of Developmental Translational Research, National Institute of Mental Health; Dr. Guyer is with the Massachusetts Mental Health Center; Dr. Kaufman is with the Department of Psychiatry, Yale Medical School; and Dr. Merikangas is with the Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health.
Merikangas
Kathleen R
KR
Drs. Kessler, Green, He, and Zaslavsky, Mr. Gruber, and Ms. Sampson are with the Department of Health Care Policy, Harvard Medical School; Dr. Avenevoli is with the Division of Developmental Translational Research, National Institute of Mental Health; Dr. Guyer is with the Massachusetts Mental Health Center; Dr. Kaufman is with the Department of Psychiatry, Yale Medical School; and Dr. Merikangas is with the Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health.
D000293:Adolescent; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology