Stability and Natural History of DSM-III Childhood Diagnoses

Cantwell, Dennis P.; Baker, Lorian

doi:10.1097/00004583-198909000-00009

Cited by 156 publications

(62 citation statements)

References 37 publications

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“…The implication of this explanation is that no treatment is superior to no treatment. But recent longitudinal research [64, 65]and retrospective studies suggest that this belief may be overly optimistic [65, 66, 67, 68, 69]. An alternative hypothesis is that the positive changes result from the approach used during assessment.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Brief Dynamic Psychotherapy for Children with Emotional Disorders

Muratori¹,

Picchi²,

Casella³

et al. 2001

Psychother Psychosom

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Background: Child psychiatry has enjoyed a long tradition of using brief psychotherapy with children, but research on its efficacy and effectiveness in the setting of routine clinical care is remarkably sparse; the aim of this study was to evaluate the efficacy of an original model of brief psychodynamic psychotherapy (BPP) for children with emotional disorders in a clinical outpatient setting. Methods: A sample of 30 subjects (6.3–10.9 years old) was divided into an experimental BPP group and a control group. Each subject was evaluated at the beginning, after 6 months and at an 18-months follow-up. Outcome measures were Children’s Global Assessment Scale and Child Behavior Check-List. Statistical and clinical significance of change were evaluated. Results: At the first evaluation, the experimental group showed a better improvement in global functioning; at follow-up, the two groups improved to a comparable degree, but only the mean of the experimental group moved to a functional range. The experimental group showed a significant reduction in total behavioral problems and externalizing problems at the follow-up. Conclusions: The better improvement of the experimental group in two outcome measures suggests that BPP is efficient in emotional disorders. The hypothesis that BPP introduces changes at long term (sleeper effects) is suggested. The improvement in global functioning of the two groups is discussed in relation to specific characteristics of emotional disorders. Finally, limitations of the study are discussed and in particular the bias introduced by lack of randomization.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Brief Dynamic Psychotherapy for Children with Emotional Disorders

Muratori¹,

Picchi²,

Casella³

et al. 2001

Psychother Psychosom

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“…Os transtornos ansiosos e os transtornos disruptivos do comportamento (transtorno opositivo-desafiador e de conduta) foram significativamente mais encontrados nos casos com hiperatividade, o que vai ao encontro dos resultados de outros autores 10,13,[16][17][18][19] . Entretanto, é digno de nota a maior prevalência de transtorno de conduta em relação ao transtorno opositivo-desafiador.…”

Section: Homensunclassified

Comorbidade em crianças e adolescentes com transtorno do déficit de atenção: resultados preliminares

Souza

Serra

Mattos

et al. 2001

Arq. Neuro-Psiquiatr.

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RESUMO -Trinta e quatro crianças e adolescentes com idades entre 6 e 16 anos, com diagnóstico de transtorno do déficit de atenção com hiperatividade (TDAH) segundo a DSM-IV, foram examinadas e avaliadas quanto a comorbidade com outros transtornos psiquiátricos através do questionário padronizado P-CHIPS aplicado aos pais. Observou-se expressiva ocorrência de transtornos comórbidos (85,7%), sendo o transtorno opositivodesafiador (20,6%) e o transtorno de conduta (39,2%) os mais comuns. Pelo menos dois outros diagnósticos que não o de TDAH puderam ser observados em 57% da amostra. A depressão maior pode ser diagnosticada em quatro casos e quadros ansiosos (transtorno de ansiedade generalizada, ansiedade de separação e fobias) foram observados em 34,3% da amostra. A presença de comorbidade altera de modo significativo o prognóstico da enfermidade e pode sugerir estratégias terapêuticas específicas dependendo de cada caso. A comorbidade frequente também pode sugerir a necessidade do uso de entrevistas diagnósticas que contemplam outros transtornos psiquiátricos. PALAVRAS-CHAVE: atenção, TDAH, comorbidade. Comorbidity among children and adolescents with attention-deficit disorder: preliminary resultsABSTRACT -Thirty-four children and adolescents with ages from 6 to 16 years having a diagnosis of attentiondeficit hyperactivity disorder (ADHD)according to DSM-IV criteria were examined. Psychiatric comorbidity was evaluated through a standard questionnaire given to parents. There was a significant comorbidity (85,7%) in the sample, oppositional-defiant disorder (20,6%) and conduct disorder (39,2%) being the most common comorbid diagnosis. At least two diagnosis other than ADHD could be found in 57% of the sample. Major depression was seen in four cases and anxiety states (generalized anxiety disorder, separation anxiety and phobias) were seen in 34.3% of the sample. Comorbidity modifies prognosis in a significant way and may suggest specific therapeutic interventions according to each case. Frequente comorbidity may suggest the need for diagnostic interviews that covers other psychiatric disorders.KEY WORDS: attention, ADHD, comorbidity. . Estes valores podem variar em função do modo como é feito o diagnóstico (utilizando-se critérios da Associação Psiquiátrica Americana, o Diagnostic and Statistical Manual 4, em entrevista clínica ou estruturada, critérios neuropsicológicos, ou outros.) O TDAH associa-se com significativo comprometimento funcional em diversas áreas (acadêmica, profissional, social) e, à medida que o indivíduo cresce, ocorrem também taxas crescentes de comorbidade psiquiátrica 3 . A presença de comorbidade com transtornos comportamentais, transtornos do humor (depressão e transtorno bipolar), transtornos de ansiedade, abuso de álcool e drogas aumenta o comprometimento observado em uma significativa parcela destes indivíduos. Estudos de comorbidade revelaram taxas elevadas de ocorrência com outros transtornos psiquiátricos, em especial os transtornos do humor, os transtornos ansiosos e os transtornos dis...

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“…High stability was found only for the diag noses of infantile autism, attention deficit dis order with hyperactivity and oppositional dis order. Conduct disorder had poor stability [9]. So long as psychiatric diagnosis remains so clinically based, one can expect that instabil ity of diagnoses will continue.…”

Section: Discussionmentioning

confidence: 99%

Stability of Psychiatric Diagnoses among Acutely III Patients

Hollister¹

1992

Psychopathology

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A survey of patients admitted four or more times to the same acute care psychiatric hospital over a period of 3 years revealed that only 56 of 162 (34%) of such patients were discharged with the same diagnosis on each admission. Instability of diagnosis occurred despite the fact that previous diagnoses were known and that only relatively few diagnoses contributed to this degree of chronicity. Schizophrenia and mania were the most stable diagnoses with considerable overlap between them. Organic disorders were a variable diagnosis, often made in the context of chronicity, substance abuse or uncertainty. A diagnosis of substance abuse usually occurred in the context of other comorbid diagnoses which sometimes took precedence. Instability of diagnosis will continue so long as the diagnostic system is based so heavily on clinical criteria.

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Stability and Natural History of DSM-III Childhood Diagnoses

Cited by 156 publications

References 37 publications

Efficacy of Brief Dynamic Psychotherapy for Children with Emotional Disorders

Efficacy of Brief Dynamic Psychotherapy for Children with Emotional Disorders

Comorbidade em crianças e adolescentes com transtorno do déficit de atenção: resultados preliminares

Stability of Psychiatric Diagnoses among Acutely III Patients

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