AIM: To investigate child and adolescent psychiatrists'(CAPs) attention deficit hyperactivity disorder(ADHD) and oppositional defiant disorder(ODD) diagnoses and treatments in real-world clinical practice. METHODS...AIM: To investigate child and adolescent psychiatrists'(CAPs) attention deficit hyperactivity disorder(ADHD) and oppositional defiant disorder(ODD) diagnoses and treatments in real-world clinical practice. METHODS: The medical records of 69 ADHD children(mean age = 9.5 years), newly referred to the ADHD clinic, were reviewed for their scores of parent- and teacher-reported Vanderbilt ADHD Diagnostic Rating Scales(VADRSs), CAPs' diagnoses of ADHD and ODD, and CAPs' treatment recommendations. Among 63 ADHD subjects who completed both parent and teacher VADRSs, we examined the agreement of the parent and teacher VADRSs. We also examined the concurrent validity of CAPs' ODD diagnoses against the results from the VADRSs. In addition, we compared CAPs' treatment recommendations against established ADHD and ODD guidelines.RESULTS: Among 63 ADHD subjects, the majority of the subjects(92%) met full ADHD diagnostic criteria at least in one setting(parent or teacher) on the VADRSs. Nearly half of the patients met full ADHD diagnostic criteria in two settings(parent and teacher). Relatively low agreement between the parent and teacher VADRSs were found(95%CI:-0.33 to 0.14). For 29 children who scored positive for ODD on the rating scales, CAPs confirmed the ODD diagnosis in only 12 of these casepositives, which is considered as a fair agreement between CAPs and VADRSs(95%CI: 0.10-0.53). For 27 children with no ODD diagnosis made by either CAP or VADRS, more than half of them were recommended for medication only. In contrast, where CAPs made the diagnosis of ODD, or where the parent or teacher VADRS was positive for ODD, almost all of the patients received recommendations for medication and behavior therapy.CONCLUSION: CAPs' ADHD diagnoses have strong concurrent validity against valid rating scales, but ADHD's most common comorbid condition- ODD- may be underrecognized.展开更多
目的对第二版范德堡头颈症状调查量表(Vanderbilt head and neck symptom survey,Version 2.0,VHNSS 2.0)进行汉化,并对其信度、效度进行初步检验。方法采用Brislin翻译和回译法,经5位专家咨询,对VHNSS 2.0进行汉化和跨文化调适,形成中...目的对第二版范德堡头颈症状调查量表(Vanderbilt head and neck symptom survey,Version 2.0,VHNSS 2.0)进行汉化,并对其信度、效度进行初步检验。方法采用Brislin翻译和回译法,经5位专家咨询,对VHNSS 2.0进行汉化和跨文化调适,形成中文版量表,将量表应用在450例头颈癌(head and neck cancer,HNC)放疗患者中进行调查,采用项目分析、内容效度、探索性因子分析、Cronbachα系数、折半信度、反应度对量表信度、效度进行检验。结果翻译后中文版VHNSS 2.0量表共有50个条目(13个维度),416例患者完成调查研究,其中量表中条目27(使用止疼药)与条目43(假牙)2个条目由于调查对象没有使用止疼药、假牙者,条目无计分,只有48个条目进入项目与信度、效度分析。相关系数结果显示,各条目与总分的相关系数,除条目42的相关系数值为0.242(删除该条目),其余各条目相关系数值在0.318~0.735,均有统计学意义(均P<0.05)。条目水平内容效度指数为0.800~1.000,量表水平内容效度指数为0.932;探索性因子分析共提取10个公因子,累计方差贡献率73.303%;量表的Cronbachα系数为0.958,折半信度为0.865。中文版VHNSS 2.0量表最后保留47个条目(10个维度)。结论汉化版VHNSS 2.0具有良好的信度、效度,可以用于中国HNC放疗患者的治疗相关症状发生情况和严重程度的评估。展开更多
基金funding from NIMH, AHRQ, Marriott Foundation, Mayo Foundation
文摘AIM: To investigate child and adolescent psychiatrists'(CAPs) attention deficit hyperactivity disorder(ADHD) and oppositional defiant disorder(ODD) diagnoses and treatments in real-world clinical practice. METHODS: The medical records of 69 ADHD children(mean age = 9.5 years), newly referred to the ADHD clinic, were reviewed for their scores of parent- and teacher-reported Vanderbilt ADHD Diagnostic Rating Scales(VADRSs), CAPs' diagnoses of ADHD and ODD, and CAPs' treatment recommendations. Among 63 ADHD subjects who completed both parent and teacher VADRSs, we examined the agreement of the parent and teacher VADRSs. We also examined the concurrent validity of CAPs' ODD diagnoses against the results from the VADRSs. In addition, we compared CAPs' treatment recommendations against established ADHD and ODD guidelines.RESULTS: Among 63 ADHD subjects, the majority of the subjects(92%) met full ADHD diagnostic criteria at least in one setting(parent or teacher) on the VADRSs. Nearly half of the patients met full ADHD diagnostic criteria in two settings(parent and teacher). Relatively low agreement between the parent and teacher VADRSs were found(95%CI:-0.33 to 0.14). For 29 children who scored positive for ODD on the rating scales, CAPs confirmed the ODD diagnosis in only 12 of these casepositives, which is considered as a fair agreement between CAPs and VADRSs(95%CI: 0.10-0.53). For 27 children with no ODD diagnosis made by either CAP or VADRS, more than half of them were recommended for medication only. In contrast, where CAPs made the diagnosis of ODD, or where the parent or teacher VADRS was positive for ODD, almost all of the patients received recommendations for medication and behavior therapy.CONCLUSION: CAPs' ADHD diagnoses have strong concurrent validity against valid rating scales, but ADHD's most common comorbid condition- ODD- may be underrecognized.
文摘目的对第二版范德堡头颈症状调查量表(Vanderbilt head and neck symptom survey,Version 2.0,VHNSS 2.0)进行汉化,并对其信度、效度进行初步检验。方法采用Brislin翻译和回译法,经5位专家咨询,对VHNSS 2.0进行汉化和跨文化调适,形成中文版量表,将量表应用在450例头颈癌(head and neck cancer,HNC)放疗患者中进行调查,采用项目分析、内容效度、探索性因子分析、Cronbachα系数、折半信度、反应度对量表信度、效度进行检验。结果翻译后中文版VHNSS 2.0量表共有50个条目(13个维度),416例患者完成调查研究,其中量表中条目27(使用止疼药)与条目43(假牙)2个条目由于调查对象没有使用止疼药、假牙者,条目无计分,只有48个条目进入项目与信度、效度分析。相关系数结果显示,各条目与总分的相关系数,除条目42的相关系数值为0.242(删除该条目),其余各条目相关系数值在0.318~0.735,均有统计学意义(均P<0.05)。条目水平内容效度指数为0.800~1.000,量表水平内容效度指数为0.932;探索性因子分析共提取10个公因子,累计方差贡献率73.303%;量表的Cronbachα系数为0.958,折半信度为0.865。中文版VHNSS 2.0量表最后保留47个条目(10个维度)。结论汉化版VHNSS 2.0具有良好的信度、效度,可以用于中国HNC放疗患者的治疗相关症状发生情况和严重程度的评估。
