Ψυχομετρικές ιδιότητες της Ημι-δομημένης Ψυχιατρικής Διαγνωστικής Συνέντευξης για Παιδιά και Εφήβους Kiddie – Schedule for Affective Disorders and Schizophrenia – Present and Lifetime version (K-SADS/PL-DSM-5) σε ελληνικό πληθυσμό

Η ημι-δομημένη Ψυχιατρική Διαγνωστική Συνέντευξη για Παιδιά και Εφήβους Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime version (K-SADS-PL), αποτελεί μία από τις πιο γνωστές και ευρέως χρησιμοποιούμενες ψυχιατρικές συνεντεύξεις για παιδιά και εφήβους. Προκειμένου, να συμβαδίζει με τις αλλαγές που έχουν πραγματοποιηθεί στο DSM-5, η ελληνική μετάφραση του εργαλείου (K-SADS/PL-DSM 4), χρειάζεται να προσαρμοστεί και να αξιολογηθούν οι ψυχομετρικές του ιδιότητες. Δεδομένα από 113 φακέλους παιδιών και εφήβων ηλικίας 7-17 ετών χρησιμοποιήθηκαν για να συμπληρωθεί το αναβαθμισμένο εργαλείο (K-SADS/PL-DSM-5) και να αξιολογηθούν η αξιοπιστία μεταξύ των βαθμολογητών και η συναινετική εγκυρότητα. Επίσης, αξιολογήθηκαν η συντρέχουσα εγκυρότητα του εργαλείου σε σχέση με το Ερωτηματολόγιο Παιδικής Κατάθλιψης (Children’s Depression Inventory-CDI), καθώς και η ευαισθησία, η ειδικότητα και η θετική/αρνητική προγνωστική αξία για τις διαγνωστικές κατηγορίες των καταθλιπτικών διαταραχών. Η αξιοπιστία μεταξύ των βαθμολογητών βρέθηκε καλή έως εξαιρετική (Cohen’s kappa Coefficient=0,72-0,84, p<0,001) για το σύνολο των διαγνώσεων που μελετήθηκαν . Για τη συναινετική εγκυρότητα ο δείκτης kappa είχε ένα εύρος k=0,49-0,82 , με την πλειοψηφία των διαγνώσεων να παρουσιάζει εξαιρετική συμφωνία (k>0,75). Ακόμα, το εργαλείο παρουσιάζει συντρέχουσα εγκυρότητα με το CDI, καθώς και πολύ καλή ευαισθησία(88,6%),ειδικότητα(79,2%),θετική(86,1%) και αρνητική (82,6%) προγνωστική αξία για τις διαγνωστικές κατηγορίες της Μείζονος Κατάθλιψης και της Δυσθυμίας. Η παρούσα έρευνα έδειξε ότι η ελληνική έκδοση του K-SADS/PL-DSM-5 αποτελεί ένα έγκυρο και αξιόπιστο εργαλείο , που μπορεί να χρησιμοποιηθεί με επάρκεια για τη διάγνωση αρκετών μείζονων ψυχιατρικών διαταραχών σε παιδιά και εφήβους. Περισσότερες μελέτες θα ήταν καλό να διενεργηθούν για την επιβεβαίωση των ευρημάτων.The Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime version (K-SADS-PL), is one of the most well-known and widely used psychiatric interviews for children and adolescents. In order to keep the instrument in line with the DSM-5, the Greek translation of the interview (K-SADS/PL-DSM 4) was updated and evaluated. Data from 113 files of children and adolescents aged 7-17 years were used to complete the updated interview (K-SADS/PL-DSM-5) and to calculate inter-rater reliability and consensual validity. Concurrent validity to CDI, as well as the sensitivity, specificity and positive / negative prognostic value for the diagnostic categories of depressive disorders were also calculated. Inter-rater reliability was good to excellent (k = 0.72-0.84, p <0.001) for all diagnoses. Kappa value for consensual validity had a range k = 0.49-0.82, with the majority of diagnoses showing excellent agreement (k> 0.75). Also, concurrent validity with CDI, as well as sensitivity(88,6%),specificity(79,2%),positive(86,1%) and negative(82,6%) prognostic value for the diagnostic categories of Major Depression and Dysthymia, was very good. Τhe present study showed that the Greek version of K-SADS / PL-DSM-5 is a valid and reliable instrument, which can be used adequately to diagnose several major psychiatric disorders in children and adolescents. Nevertheless, more studies are needed to confirm our findings

Navigating young minds: reliability and validity of the Greek version of kiddie – schedule for affective disorders and schizophrenia – present and lifetime DSM-5 version (K-SADS-PL-GR-5)

Abstract Background The Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL) is one of the most popular semi-structured psychiatric interviews for children and adolescents. Its latest DSM-5 version (K-SADS-PL DSM-5) has only recently been adapted and validated in various languages. In the present study, we aimed to investigate the reliability and validity of the Greek version of the K-SADS-PL DSM-5. Methods A total of 137 patients consecutively referred for admission, aged 7–17, were included. The K-SADS-PL DSM-IV was translated and adapted to correspond to DSM-5 categories. Convergent and divergent validity were assessed against two self-report rating scales, Children’s Depression Inventory (CDI) and Screen for Child Anxiety Related Emotional Disorders (SCARED). Inter-rater reliability was calculated exclusively for instances where a diagnosis involved three or more patients. Results Our findings revealed good to excellent inter-rater reliability and good to excellent consensual validity across most psychiatric diagnoses, except for panic disorder. Diagnostic efficiency, measured by sensitivity, specificity, positive and negative predictive values, consistently showed high specificity and negative predictive validity across all diagnostic categories. Conclusions These findings support the applicability of the Greek version of the K-SADS-PL DSM-5 as a reliable and valid diagnostic tool in Greek-speaking populations

Comparing Apples and Oranges in Youth Depression Treatments? A Quantitative Critique of the Evidence Base and Guidelines

Question: Should a young person receive psychotherapy or medication for their depression, and on what evidence do we base this decision? In this paper, we test whether the basic conditions required to draw valid inferences to answer this question are currently met. Study selection and analysis: We included 88 RCTs of psychotherapy and medication for child and adolescent depression (mean age 4-18 years). Using meta-analyses, we compared a) participant characteristics and b) trial characteristics in medication and psychotherapy trials. Lastly, we examined whether psychotherapy controls are well-matched to active conditions. Findings: Participants in medication RCTs had higher depression severity and were more frequently male compared to psychotherapy RCTs. There was a dramatic difference in the within-subject improvement due to placebo (SMD=-1.9 (95% CI: -2.10 to -1.70)) vs psychotherapy controls (SMD=-0.5 (95% CI: -0.75 to -0.25)). Within psychotherapy RCTs, control conditions were less intensive on average than active conditions. Conclusions: Medication and psychotherapy RCTs differ on fundamental participant and methodological characteristics, thereby violating key conditions for valid comparison between them. Psychotherapy controls often involve little therapist contact and are easy-to-beat comparators. These findings cast doubt on the confidence with which psychotherapy is recommended for youth depression, and highlight the pressing need to improve the evidence base