Abstract
The development and well-being assessment (DAWBA) has been used in various epidemiological studies, whereas the clinical value
of the instrument needs support from further studies. In particular, it is important to document how the use of the DAWBA
influences clinical decision-making. The present study employed the DAWBA in a consecutive series of 270 new referrals to
a large public child and adolescent psychiatric service in Zurich, Switzerland. ICD-10 based diagnoses were obtained from
clinicians for all patients and reliability of DAWBA expert raters was calculated. The DAWBA diagnoses were randomly disclosed
(n = 144) or not disclosed (n = 126) before clinical decision-making. The reliability of DAWBA expert diagnoses was very satisfactory and the agreement
under the disclosed versus the non-disclosed condition amounted to 77 versus 68 % for internalizing disorders and to 63 versus
71 % for externalizing disorders. The increment in agreement due to disclosure of the DAWBA diagnosis was significant for
internalizing disorders. Access to DAWBA information was more likely to prompt clinicians to add an extra diagnosis. Professional
background and degree of clinical experience did not affect diagnostic agreement. Overall, diagnostic agreements between DAWBA
expert diagnoses and clinical diagnoses were in the fair to moderate range and comparable to previous studies with other structured
diagnostic interviews. The inclusion of the DAWBA into the clinical assessment process had an impact on diagnostic decision-making
regarding internalizing disorders but not regarding externalizing disorders.
of the instrument needs support from further studies. In particular, it is important to document how the use of the DAWBA
influences clinical decision-making. The present study employed the DAWBA in a consecutive series of 270 new referrals to
a large public child and adolescent psychiatric service in Zurich, Switzerland. ICD-10 based diagnoses were obtained from
clinicians for all patients and reliability of DAWBA expert raters was calculated. The DAWBA diagnoses were randomly disclosed
(n = 144) or not disclosed (n = 126) before clinical decision-making. The reliability of DAWBA expert diagnoses was very satisfactory and the agreement
under the disclosed versus the non-disclosed condition amounted to 77 versus 68 % for internalizing disorders and to 63 versus
71 % for externalizing disorders. The increment in agreement due to disclosure of the DAWBA diagnosis was significant for
internalizing disorders. Access to DAWBA information was more likely to prompt clinicians to add an extra diagnosis. Professional
background and degree of clinical experience did not affect diagnostic agreement. Overall, diagnostic agreements between DAWBA
expert diagnoses and clinical diagnoses were in the fair to moderate range and comparable to previous studies with other structured
diagnostic interviews. The inclusion of the DAWBA into the clinical assessment process had an impact on diagnostic decision-making
regarding internalizing disorders but not regarding externalizing disorders.
- Content Type Journal Article
- Category Original Contribution
- Pages 1-9
- DOI 10.1007/s00787-012-0293-6
- Authors
- Marcel Aebi, Department of Child and Adolescent Psychiatry, University of Zurich, Zurich, Switzerland
- Christine Kuhn, Department of Child and Adolescent Psychiatry, University of Zurich, Zurich, Switzerland
- Christa Winkler Metzke, Department of Child and Adolescent Psychiatry, University of Zurich, Zurich, Switzerland
- Argyris Stringaris, Institute of Psychiatry, King’s College London, London, UK
- Robert Goodman, Institute of Psychiatry, King’s College London, London, UK
- Hans-Christoph Steinhausen, Department of Child and Adolescent Psychiatry, University of Zurich, Zurich, Switzerland
- Journal European Child & Adolescent Psychiatry
- Online ISSN 1435-165X
- Print ISSN 1018-8827