Comparison of ICD-10 and DC: 0-3R Diagnoses in Infants, Toddlers and Preschoolers

Abstract

The purpose of this study was to analyze and compare diagnoses of patients from a special outpatient department for infants, toddlers and preschoolers. Specifically, overlap, age and gender differences according to the two classification systems DC: 0-3R and ICD-10 were examined. 299 consecutive children aged 0-5; 11 years received both ICD-10 and DC: 0-3R diagnoses. All ICD-10 diagnoses were given prospectively at the initial contact. The DC: 0-3R diagnoses were allotted in mutual consensus conferences. The most common ICD-10 disorders were Oppositional Defiant (ODD), Hyperkinetic (HKD) and Emotional Disorders. In DC: 0-3R, nearly half of the children could not be coded adequately ('Other Disorders'). Sleep Behavior Disorders were followed by Feeding Behavior and Regulation Disorders. Both classification systems are needed in infant, toddler and preschool psychiatry. There is a good concordance of the two systems for Feeding, Sleeping, Adjustment and Attachment Disorders, whereas the ICD-10 diagnoses HKD and ODD are not adequately represented in DC: 0-3R.

Clinical effectiveness and cost-effectiveness of parenting interventions for children with severe attachment problems: a systematic review and meta-analysis

“…Thirty-three studies were published between 1988 and 2011, of which the majority were undertaken in the USA (n = 18 24,47,93,94,[96][97][98][99][100][102][103][104]106,111,113,115,116,118,121 ), with the rest spread across the UK (n = 4 50,52,[107][108][109] ), Canada (n = 4 25,105,110,119 ), Germany (n = 2 101,122 ), the Netherlands (n = 2 117,120 ), Romania (n = 1 94 ) and Spain (n = 1 114 ). Table 1 and Box 1.…”

“…24,25,47,50,52,[93][94][95][96][99][100][101][102][104][105][106][107][108][111][112][113][114][115][116][117][118][119][120][121][122] In those studies providing demographic detail, parental age ranged from 12 to 70 years and ethnicity was predominantly white or Caucasian.…”

“…Equit and colleagues 101 reference the use of ICD-10 55 as the method for detecting attachment disorders; however, as this is a full assessment (reflected in the cost) and not specific to attachment, this outlying cost is excluded within the mean cost of identification.…”

“…Based on the four studies of identification strategies, three studies were used to estimate the average cost of identification procedure for a RAD as £109 (omitting Equit and colleagues 101 given the length of procedure reported indicates a full psychiatric assessment and not a specific assessment of an attachment disorder). Given that prevalence is found to be 1.4% in the general population, this would suggest that screening a general population sample of an average CCG would identify 45 cases.…”

Inter-rater reliability and aspects of validity of the parent-infant relationship global assessment scale (PIR-GAS)

“…The DC:0–3 and the revised DC:0-3R a [2] represent a developmentally sensitive addition to the available classification systems and take key aspects of the relationship between the infant and primary caregiver into account. Therefore, the DC:0-3/DC:0-3R may complement, but not replace, existing classification systems [3,4]. …”