Computerized Screening for Comorbidity in Adolescents With Substance or Psychiatric Disorders
Condition: Psychiatric Disorder
MeSH terms: Mental Disorders; Problem Behavior
Study type: Observational

Summary: 
      The KSADS-COMP will facilitate identification of comorbid psychiatric and substance use
      diagnoses frequently missed in clinical practice, and improve adolescent treatment outcomes.
      The self-administered version of the KSADS-COMP can also be used cost-effectively in schools
      and juvenile justice settings where there is a growing interest in early identification and
      referral of youth in need of mental health services. The KSADS-Bridge assessment tool with
      its RDoC neurocognitive tasks, when completed with the self- or clinician administered
      KSADS-COMP, will help to create cross-talk between the DSM and RDoC diagnostic perspectives,
      and begin to generate a database on the relationship between RDoC constructs and treatment
      outcomes across a range of diagnostic categories.
    

Detailed description: 
      This Phase II SBIR grant is a follow-up to the Phase I SBIR grant "Computerized Screening for
      Comorbidity in Adolescents with Substance or Psychiatric Disorders." During Phase I, parent
      and adolescent self administered computerized versions of the psychiatric interview, the
      Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS), were developed to assess
      DSM-IVR diagnoses in adolescents. Since the funding of the Phase I grant, there have been two
      significant developments in the field: the American Psychiatric Association's release of the
      DSM-5 manual, and NIMH's launch of the Research Domain Criteria (RDoC) initiative that aims
      to create the necessary database to derive a new psychiatric nomenclature informed by
      neuroscience, genetics, and psychology. The primary goals of Phase II include: 1) Update the
      parent and adolescent self-administered computerized KSADS (KSADS-COMP) so it is compatible
      with DSM-5 criteria; 2) Develop software for a clinician-administered computerized KSADS
      (KSADS-COMP); 3) Create a KSADS- Bridge product that includes a battery of RDoC computerized
      neurocognitive tasks that can be completed with the self- or clinician-administered
      KSADS-COMP; and 4) Examine the criterion, convergent, and discriminant validity of the
      self-administered KSADS-COMP, and the relationship among DSM-5 diagnoses, dimensional
      measures of psychopathology, and performance on RDoC neurocognitive tasks. Ultimately the aim
      of this initiative is to create an instrument that, in addition to providing a reliable
      comprehensive assessment tool for psychiatric disorders in adolescents, can bridge DSM-5 and
      RDoC diagnostic perspectives. A sample of 400 adolescents and their parents will be recruited
      for this study: half will complete the self-administered KSADS-COMP; the other half will
      complete the clinician-administered KSADSCOMP. All 400 adolescents and their parents, in
      addition to completing one of the KSADS-COMP versions, will also complete a battery of
      dimensional symptom rating scales. A subset of 210 adolescents and their parents will then
      complete the other version of the KSADS-COMP to test diagnostic concordance between the self-
      and clinician-administered KSADS-COMP. To obtain reliable Kappa estimates, this subset will
      include 30 adolescents with no psychopathology and 30 adolescents that meet criteria for each
      of the following diagnoses: conduct disorder, major depression, bipolar; substance use
      disorders; post traumatic stress disorder; and attention deficit hyperactivity disorder. This
      subset of 210 adolescents will also be administered the RDoC battery of neurocognitive
      computerized tasks. The KSADS-COMP and KSADS-Bridge assessment tools will have multiple
      clinical and research applications. In addition to helping identify comorbidity in teens with
      substance or psychiatric disorders, it will help to create the cross-talk needed between the
      DSM and RDoC diagnostic perspectives, and will help to improve clinical care in the short-
      and long-run as the field aims to transition to a new psychiatric nomenclature.
    

Observational model: Cohort
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        adolescents aged 13-18 seeking psychiatric treatment at a rural mental health clinic