Correspondence between adolescent report and parent report of psychiatric diagnostic data

Objective: To examine the degree of agreement between parent and adolescent report of major psychiatric disorders in the adolescent (14 to 18 years of age). Method: A total of 281 parent-adolescent pairs were interviewed separately regarding psychopathology in the adolescent. Results: The kappa values for parent-adolescent agreement on the disorders ranged from .19 for alcohol abuse/dependence to .79 for conduct disorder, with an average kappa of .42. Excellent agreement was found for conduct disorder and the core symptom of anorexia; good agreement was found for separation anxiety disorders, attention-deficit/hyperactivity disorder, oppositional defiant disorder, substance abuse/dependence, and the core symptom for bulimia; poor agreement was found for major depression, dysthymia, anxiety disorders other than separation anxiety, alcohol abuse/dependence, and the infrequent core symptoms of bipolar and obsessive-compulsive disorders. Parent-adolescent agreement was not influenced by gender, current adolescent age, parental education level, disorder onset age, or severity of disorder. Conclusions: For detecting cases of adolescent psychopathology, there are clear advantages to the current consensus position that combines adolescent and parent report, especially for externalizing disorders. However, if forced to choose one informant, assessing the adolescent will result in the detection of more diagnosed cases.