Diagnostic implications of informant disagreement about rage outbursts: bipolar disorder or another condition?
BACKGROUND
Modest agreement between parent- and teacher-reports of child behavior is a common finding. This study examines diagnoses made when significant disparity occurs in parent- and teacher-reports of rage behaviors.


METHODS
Parents and teachers of 911 5-18 year-olds referred for psychiatric outpatient services completed rating scales and received a psychiatric evaluation blind to parent- and teacher-ratings. Children with rage outbursts (n=431, 47.2%) were assessed for diagnosis, family history, and clinical variables.


RESULTS
Children were 12.0 (3.6) years; 26.5% were female. Bipolar disorder was rare (11.2%) in this sample; however, in children with parent- and teacher-reported rages, severe mood dysregulation was the most common condition (54.4%). In parent only reported rages, anxiety disorders were most common (40.6%) diagnoses, and in teacher only reported rages, learning/language disorders were the most common (46.0%) diagnoses.


CONCLUSIONS
The context in which a rage outburst occurs may impact the diagnosis; however, diagnosis alone does not explain this difficult and impairing behavior.
Department of Child and Adolescent Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York, U.S.A.
Gabrielle A
GA
Carlson
Margaret
M
Dyson
D000293:Adolescent; D001008:Anxiety Disorders / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis*; D002675:Child, Preschool; D019260:Expressed Emotion / Q000502:physiology*; D005178:Faculty; D005260:Female; D006801:Humans; D007859:Learning Disabilities / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D010290:Parents; D011795:Surveys and Questionnaires