2011 Articles

Standardized Interviews For Diagnostic Assessments Of Children And Adolescents In Psychiatric Research

Weissman, Myrna M.

One article alone rarely changes a field and usually reflects the point prevalence of accumulated research. Moreover, any method—no matter how innovative at the time—evolves because cumulative scientific discoveries challenge existing paradigms. Nonetheless, two articles published in the Journal of the American Academy of Child and Adolescent Psychiatry on standardized diagnostic interviews stand out as research landmarks in the psychiatric assessment of children and adolescents: one by Orvaschel et al. in 1982 and another by Kaufman et al. in 1997.

I will present a historical context. The introduction of DSM-III, which included specific diagnostic criteria, improved reliability and interview tools for collecting the information to make diagnostic criteria and facilitated the modern age of psychiatric epidemiology. Beginning in the early 1980s, the first survey, the Epidemiologic Catchment Area Study, collected data on psychiatric disorders in the community and used these methods. The resulting finding on rates, risks, age of onset, and comorbidity, derived from 18,000 adults in five U.S. communities, were incorporated into research studies and clinical descriptions of psychiatric disorders. The Epidemiologic Catchment Area Study was followed by new and improved surveys in each subsequent decade. The major finding, consistent throughout the decades and shown clearly in the Epidemiologic Catchment Area Study, was that most psychiatric disorders usually had their first onset in childhood and adolescence. This finding accelerated the importance of psychiatric research in children. However, the direct assessment of children and adolescents lagged way behind the methods used in community studies of adults. Even today, there are few community surveys of children and adolescents in the United States.