In a prospective Multi-Centre research study involving four British Adolescent Psychiatry Inpatient Units, all 276 adolescent admissions were diagnosed using both ICD-9 and DSM-III. Ratings of diagnostic confidence for each diagnostic group varied considerably. Clinicians recorded high levels of confidence in the diagnosis of both Schizophrenia and Anorexia nervosa, while considerably lower scores were noted for Adjustment Disorders (ICD-9 3-digit code 309.), and for Emotional Disorders (ICD-9 3-digit code 313.). Exact concordance in diagnoses made for each case using both ICD-9 and DSM-III occurred in 72% of the entire cohort. The dissimilar concordance rates comparing ICD-9 and DSM-III diagnoses for the same patient admissions suggest differences in validity measures, such as face validity and content validity, in the reliability of diagnostic criteria between similarly named disorders across the two systems, and in the clinician's training and attitude to diagnosis. With the recent introduction of DSM-IV following upon ICD-10, further comparative studies are needed to examine both reliability and validity issues into diagnosis and classification in child and adolescent psychiatry.

A set of 16 treatment goals, related to 4 areas of adolescent functioning, were defined and employed in the initial and discharge assessments of 276 patients, admitted to 4 inpatient units, examined during a multi-centre prospective study of adolescent psychiatric hospitalizations. At discharge, subjects showed a substantial improvement across all treatment goals; least improvement was observed amongst those goals most frequently targeted. The clinical investigators consider the treatment goal definitions used in this study a meaningful way of measuring psychiatric disturbances in adolescence as well as a useful measure of change in an inpatient population. Further development of the treatment goal definitions would produce a robust clinical and audit tool.

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Sixteen Axis 5 ICD-10 codes were applied to a prospective multicentre study of 276 adolescent psychiatric inpatients. Frequency distributions were obtained for the whole cohort and separately for each of the seven main ICD-9 psychiatric diagnoses. Certain abnormal psychosocial situations were associated with particular diagnoses, and many significant correlations were found between Axis 5 codes. Factor analysis with varimax rotation produced four factors accounting for 46% of the total variance.

The patients are often able to change the music by singing or thinking of a different tune, but cannot suppress it entirely. The hallucinations generally persist unchanged for many years, during which time