K-SADS-PL DSM-5: the diagnostic interview for the evaluation of psychopathological disorders in children and adolescents
The K-SADS-PL DSM-5 is an excellent tool for the identification of the primary diagnosis and for the identification of the diagnosis in comorbidity and useful for the understanding and evolution of the psychopathological disorder found at an early age.
The K-SADS-PL DSM-5 is a diagnostic interview developed by Kauffman, Birmaher, Brent, Rao and Ryan in 1997 that evaluates psychopathological disorders in children and adolescents according to the DSM-5 criteria. It therefore takes into account both previous editions and the introduction of new developmental age disorders, such as autism spectrum disorder and disruptive mood dysregulation disorder. It is an excellent tool for identifying the primary diagnosis and for identifying the diagnosis in comorbidity. It is useful for the understanding and evolution of the psychopathological disorder found at an early age. The administration of K-SADS-PL is a rule that is carried out by an expert operator, who takes a neutral attitude and is not intended to give suggestions for answers.
The K-SADS-PL DSM-5 evaluates the following primary diagnoses:
Table 1: Diagnoses examined by the K-SADS-PL DSM-5 instrument
In order to proceed with the diagnostic interview, it is necessary, first, to carry out the following steps:
Let’s understand concretely what these stages mean and how they are structured.
Before administering the diagnostic interview, both parents and children must complete the cross-sectional symptom rating scale, consisting of 25 items that assess the severity of symptoms encountered in the past two weeks.
At this point the evaluator, in a short interview of about 15 minutes, collects information from the parents and the patient about:
The purpose of this introductory interview is to establish a setting characterized by a relaxed atmosphere for the patient and to understand if an alteration of the functioning of the child / boy has occurred. As far as parents are concerned, an attempt is made to obtain information about the developmental stages of the child, which could facilitate differential diagnosis. It is important that the assessor changes his language based on that used by the parents and the child / boy.
This interview focuses on the symptoms of the different primary diagnoses. For each symptom there are specific questions and criteria that go to investigate the various characteristic aspects of the disorder investigated. It also investigates whether what is found is a current symptom or if it occurred at other times in the child’s life. The evaluator, as he proceeds with the screening interview, notes the score that the patient obtains up to explore all the possible primary diagnoses.
Then we proceed by taking into consideration the exclusion criteria outlined for current or past episodes of the disorder. If the child does not meet the exclusion criteria for some diagnoses, a specific supplement is given (point 5).
At the end of the screening interview, in the manual, there is a card called “comprehensive diagnostic checklist” which records the supplements requested together with the dates of any previous or current episodes in the disorder.
The diagnostic supplements that can be deepened, if the patient does not meet the inclusion criteria for some diagnosis are:
The main function of these diagnostic supplements is to facilitate differential diagnosis and to provide important information before going on to evaluate, in detail, the characteristic symptoms of the various ailments.
It is a model to be completed, inserted at the end of the supplements of the K-SADS-PL manual, useful for recording current diagnostic information and salient information relating to the entire life of the patient. It also contains a session for the follow-up of the ideal checklist to have useful information on the longitudinal course of the pathology.
K-SADS-PL is the psychiatric interview for the developmental age most used in research on clinical populations. In fact, in the literature, it is possible to find a modest amount of studies that include and use it. It is translated into numerous languages including Italian, Spanish, Portuguese, French and Chinese. Its diagnostic validity has been demonstrated in differentiating the clinical populations from the controls and in differentiating the different diagnoses in the clinical samples. As regards Italy, the group of Sogos, Di Noia, Fiorello and Picchiotti, which also edited the translation of the manual into Italian, assessed its reliability on the clinical population demonstrating a congruence between the diagnosis made through K- SADS-PL and clinical observation.