title: Relation of symptom-induced impairment with other illness parameters in clinic-referred youth.
abstract: OBJECTIVE
  To examine the relation of caregiver ratings of psychiatric symptom-induced impairment with number and severity of symptoms and informant agreement in consecutive child psychiatry outpatient referrals.
  
  
  METHODS
  Parents and teachers completed a broadband DSM-IV-referenced rating scale with disorder-specific impairment for 636 youth (6-18 years). Illness parameters included impairment, number and severity of symptoms, and their combination (symptom + impairment) as well as categorical (cut-off) and dimensional scoring.
  
  
  RESULTS
  Agreement between impairment and other illness parameters showed considerable variation as a function of type of parameter, disorder, and informant, but to lesser extent age and gender. Many youth who met impairment cut-off for specific disorders did not meet symptom cut-off. Conversely, most youth who met symptom cut-off were impaired. Symptom cut-off evidenced greater convergence with impairment cut-off than combined symptom + impairment cut-offs. Severity of impairment was moderately to highly correlated with number and severity of symptoms. Parents' and teachers' ratings indicated little disorder-specific agreement about youth who met impairment cut-off, symptom cut-off, or combined symptom + impairment cut-off. Therefore, sole reliance on one informant greatly underestimates the pervasiveness of impairment.
  
  
  CONCLUSIONS
  Findings are consistent with the notion that each illness parameter represents a unique conceptual construct, which has important clinical and research implications.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, New York, NY, USA.
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Gadow
authors.forename: Aaron J
authors.initials: AJ
authors.lastname: Kaat
authors.forename: Luc
authors.initials: L
authors.lastname: Lecavalier
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001526:Behavioral Symptoms / Q000145:classification / Q000175:diagnosis*; D002648:Child; D003625:Data Collection / Q000592:standards / Q000706:statistics & numerical data; D005178:Faculty; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000145:classification / Q000175:diagnosis*; D015233:Models, Statistical; D010045:Outpatients; D010290:Parents; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D012737:Sex Factors
keywords: ADHD; Psychiatric disorder; children; diagnosis; impairment