Relation of symptom-induced impairment with other illness parameters in clinic-referred youth

Kenneth D. Gadow*, Aaron J. Kaat, Luc Lecavalier

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Objective To examine the relation of caregiver ratings of psychiatric symptom-induced impairment with number and severity of symptoms and informant agreement in consecutive child psychiatry outpatient referrals. Methods Parents and teachers completed a broadband DSM-IV-referenced rating scale with disorder-specific impairment for 636 youth (6-18 years). Illness parameters included impairment, number and severity of symptoms, and their combination (symptom + impairment) as well as categorical (cut-off) and dimensional scoring. Results Agreement between impairment and other illness parameters showed considerable variation as a function of type of parameter, disorder, and informant, but to lesser extent age and gender. Many youth who met impairment cut-off for specific disorders did not meet symptom cut-off. Conversely, most youth who met symptom cut-off were impaired. Symptom cut-off evidenced greater convergence with impairment cut-off than combined symptom + impairment cut-offs. Severity of impairment was moderately to highly correlated with number and severity of symptoms. Parents' and teachers' ratings indicated little disorder-specific agreement about youth who met impairment cut-off, symptom cut-off, or combined symptom + impairment cut-off. Therefore, sole reliance on one informant greatly underestimates the pervasiveness of impairment. Conclusion Findings are consistent with the notion that each illness parameter represents a unique conceptual construct, which has important clinical and research implications.

Original languageEnglish (US)
Pages (from-to)1198-1207
Number of pages10
JournalJournal of Child Psychology and Psychiatry and Allied Disciplines
Issue number11
StatePublished - Nov 1 2013


  • ADHD
  • Psychiatric disorder
  • children
  • diagnosis
  • impairment

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology
  • Medicine(all)


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