title: Psychiatric comorbidity in autism spectrum disorder: Correspondence between mental health clinician report and structured parent interview.
abstract: Publicly funded mental health services are critical in caring for children with autism spectrum disorder. Accurate identification of psychiatric comorbidity is necessary for effective mental health treatment. Little is known about psychiatric diagnosis for this population in routine mental health care. This study (1) examined correspondence between psychiatric diagnoses reported by mental health clinicians and those derived from a structured diagnostic interview and (2) identified predictors of agreement between clinician-reported and diagnostic interview-derived diagnoses in a sample of 197 children aged 4-14 years with autism spectrum disorder receiving mental health services. Data were drawn from a randomized effectiveness trial conducted in publicly funded mental health services. Non-autism spectrum disorder diagnoses were assessed using an adapted version of the Mini-International Neuropsychiatric Interview, parent version. Cohen's kappa was calculated to examine agreement between Mini-International Neuropsychiatric Interview, parent version and clinician-reported diagnoses of comorbid conditions. Children met criteria for an average of 2.83 (standard deviation = 1.92) Mini-International Neuropsychiatric Interview, parent version diagnoses. Agreement was poor across all diagnostic categories (κ values: 0.06-0.18). Logistic regression identified child gender and clinical characteristics as significant predictors of agreement for specific diagnoses. Results underscore the need for training mental health clinicians in targeted assessment of specific psychiatric disorders and prioritizing treatment development and testing for specific diagnoses to improve care for children with autism spectrum disorder served in publicly funded mental health settings.
authors.affiliation: 1 University of California, San Diego, USA.|2 Child and Adolescent Services Research Center, San Diego, USA.
authors.forename: Nicole
authors.initials: N
authors.lastname: Stadnick
authors.affiliation: 1 University of California, San Diego, USA.|2 Child and Adolescent Services Research Center, San Diego, USA.|3 Autism Discovery Institute at Rady Children's Hospital, San Diego, USA.
authors.forename: Colby
authors.initials: C
authors.lastname: Chlebowski
authors.affiliation: 1 University of California, San Diego, USA.|2 Child and Adolescent Services Research Center, San Diego, USA.|3 Autism Discovery Institute at Rady Children's Hospital, San Diego, USA.|4 Rady Children's Hospital, San Diego, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Baker-Ericzén
authors.affiliation: 1 University of California, San Diego, USA.|2 Child and Adolescent Services Research Center, San Diego, USA.|4 Rady Children's Hospital, San Diego, USA.
authors.forename: Margaret
authors.initials: M
authors.lastname: Dyson
authors.affiliation: 2 Child and Adolescent Services Research Center, San Diego, USA.|5 University of San Diego, USA.
authors.forename: Ann
authors.initials: A
authors.lastname: Garland
authors.affiliation: 1 University of California, San Diego, USA.|2 Child and Adolescent Services Research Center, San Diego, USA.|3 Autism Discovery Institute at Rady Children's Hospital, San Diego, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Brookman-Frazee
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D000067877:Autism Spectrum Disorder / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D019955:Conduct Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D008605:Mental Health Services; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D010290:Parents; D011570:Psychiatry; D011584:Psychology; D000068217:Social Workers
keywords: autism spectrum disorder; community mental health; diagnostic correspondence; psychiatric comorbidity