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The Relevance of Childhood Psychiatric Disorder for Pediatric Primary Care Consultations-Reply

Elizabeth J. Costello, PhD
Arch Gen Psychiatry. 1990;47(1):89-90. doi:10.1001/archpsyc.1990.01810130091013.
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In Reply.—  Dr Garralda raised an issue with which researchers on child psychiatric disorders in the community are still struggling: the extent to which differences in prevalence rates are due to differences in methods of data collection and diagnostic procedures rather than differences in the populations studied. In our study we reported a 6-month prevalence rate of 11% based on computer diagnosis of interviews with parents. The experienced clinicians who carried out the interviews also made their own diagnoses, blind to the computer diagnoses, and reported one or more DSM-III disorders in 49% of the children, more than twice the rate reported by Garralda and Bailey.1 In an attempt to understand this high rate of diagnosis, we compared both computer and clinician diagnoses with the parents' reports of children's emotional and behavioral problems using the Child Behavioral Checklist.2Taking as a cutoff the scores reported by Achenbach and


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