Children and adolescents who have anxiety, depression, stress-related disorders, ADHD, and disruptive behavior disorders may present with symptoms that are different than those typically seen in adults. With these developmental differences in mind, the new ICD-11 diagnostic guidelines have included sections to capture the ways disorders and symptoms may look different during childhood.
In a recent study led by Dr. Rebeca Robles, in collaboration with international colleagues and Columbia faculty members Dr. Tahilia Rebello and Dr. Geoffrey Reed, tested if clinicians can use these ICD-11 guidelines to arrive at consistent diagnoses when evaluating children and adolescents in clinical settings in Mexico City. First, they studied the degree of agreement between clinicians who were asked to diagnose the same child or adolescent after a clinical assessment. The research team found that there was moderate agreement between clinicians (inter-rater reliability) for diagnosing mood, anxiety, stress-related disorders, and attention-deficit hyperactivity disorder (ADHD), and there was strong inter-rater reliability for diagnosing disruptive behavioral disorders in children and adolescents. Additionally, 80% of clinicians felt that the ICD-11 guidelines were easy to use, detailed in capturing developmental presentations of children and adolescents, were helpful in guiding treatment, and useful when educating children and families.
This study has significant implications, as the moderate to strong inter-rater reliability of the ICD-11 guidelines validates the conceptualization of certain symptoms in children and adolescents, and the high clinical utility reported suggests the ICD-11 is likely a useful tool that can be disseminated among child and adolescent practitioners in the Latin American region.