title: Enhanced screening for posttraumatic stress disorder and comorbid diagnoses in children and adolescents.
abstract: BACKGROUND
  Posttraumatic stress disorder (PTSD) can be a debilitating disorder and often co-occurs with other psychiatric disorders, such as mood, behavioral, and anxiety disorders. Early identification of PTSD and psychiatric comorbidity is highly relevant in order to offer children appropriate and timely treatment. The Children's Revised Impact of Event Scale (CRIES-13) is a reliable and valid self-report measure designed to screen children for PTSD. However, this measure is not useful as a screen for psychiatric comorbidity in children with probable PTSD.
  
  
  OBJECTIVE
  This study evaluated the screening accuracy of the CRIES-Plus, that is, the CRIES-13 combined with 12 additional items to detect psychiatric comorbidity.
  
  
  METHODS
  The CRIES-Plus was completed by 398 Dutch children (7-18 years) exposed to various traumatic events. Psychiatric diagnoses were assessed using the Anxiety Disorders Interview Schedule for DSM-IV: Child version.
  
  
  RESULTS
  Six additional items were significantly associated with mood disorders, three items were associated with behavioral disorders, and five items with anxiety disorders. Additional items associated with mood and anxiety disorders demonstrated good discriminatory ability, with cut-off scores of ≥14 and ≥10, respectively. Items associated with behavioral disorders had poor to fair discriminatory ability, with no clear cut-off point.
  
  
  CONCLUSIONS
  Our findings support the use of the CRIES-Plus to screen for PTSD and comorbid disorders which may help clinicians in assigning appropriate follow-up diagnostic and clinical care.
authors: Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.|De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands; verlinden.eva@gmail.com.
authors: Eva
authors: E
authors: Verlinden
authors: Clinical Research Unit, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors: Brent C
authors: BC
authors: Opmeer
authors: Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.|De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands.
authors: Els P M
authors: EP
authors: Van Meijel
authors: De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands.
authors: Renée
authors: R
authors: Beer
authors: GGZ Rivierduinen, Psychotraumacenter for Children and Youth, Leiden, The Netherlands.
authors: Carlijn
authors: C
authors: De Roos
authors: National Psychotraumacenter for Children and Youth, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: Iva A E
authors: IA
authors: Bicanic
authors: Children's and Youth Trauma Center, Haarlem, The Netherlands.
authors: Francien
authors: F
authors: Lamers-Winkelman
authors: Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors: Miranda
authors: M
authors: Olff
authors: Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.|De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands.
authors: Frits
authors: F
authors: Boer
authors: Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.|De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands.
authors: Ramón J L
authors: RJ
authors: Lindauer
keywords: CRIES; PTSD; adolescents; assessment; children; diagnosis; screening; trauma