User:Rkang101/Kiddie Schedule for Affective Disorders and Schizophrenia

The kiddie schedule for affective disorders and schizophrenia is an interview-styled test aimed at early diagnosis of affective disorders such as depression, bipolar disorder, and anxiety disorder. There are currently 7 different versions of the test that are structured to include interviews with both the child and the parents or guardians.

Overview
K-SADS, Kiddie Schedule for Affective Disorders and Schizophrenia, serves to diagnose childhood mental disorders in school-aged children 6-18. The different adaptations of the K-SADS were written by different researchers and are used to screen for many affective and schizophrenic disorders. All versions of the K-SADS are semi-structured interviews given by health care providers, which gives more flexibility to the interviewer about how to phrase and probe items, while still covering a consistent set of disorders. Due to the semi-structured interview format of the assessment, time to give assessment varies from patient to patient. Most versions of the K-SADS also include "probes", which the clinician are encouraged to use for further diagnoses when patients display symptoms that point to one particular disorder.

Versions
The K-SADS currently have 7 different versions.

KSADS-PL
The K-SADS-PL (Present and Lifetime version) is used to screen for affective and schizophrenic disorders including, but not limited to Major Depressive Disorder, Mania, Bipolar Disorders, Schizophrenia, Schizoaffective Disorder, Generalized Anxiety, Obsessive Compulsive Disorder, Attention Deficit Hyperactivity Disorder, Conduct Disorder, Anorexia Nervosa, Bulimia, and Post-Traumatic Stress Disorder. This semi-structured interview takes 45-75 minutes to administer. It was written by Joan Kaufman, Ph.D., Boris Birmaher, M.D., David Brent, M.D., Uma Rao, M.D., and Neal Ryan, M.D. The majority of the items in the K-SADS-PL are scored using a 0-3 point rating scale. Scores of 0 indicate no information is available; scores of 1 suggest the symptom is not present; scores of 2 indicate sub-threshold K-SADS-PL. The KSADS-PL is given in the six parts:

Unstructured Introductory Interview

Using a scoring sheet, the unstructured introductory interview is the first part of the KSADS test that asks about demographic information, physical and mental health history and treatments, current complaints, and child’s relations with friends, family, school, and hobbies. This section allows flexibility for the interviewer to collect more information on questions that need elaboration.

Diagnostic Screening Interview

The diagnostic screening interview looks at the most severe current and past symptoms, probes, and scores according to scoring criteria for each symptom presented. If the patient does not display any current or past symptoms, the rest of the parts do not need to be given. Specific "probes" and scoring measures attached to the K-SADS-PL in order to further assess each symptom.

Supplement Completion Checklist

A supplemental checklist is used when a patient screens positive for a specific disorder that tells more about that particular, related disorder, including past and current episodes.

Appropriate Diagnostic Supplements

Like the supplement completion checklist, the appropriate diagnostic supplements tests the severity of current and past symptoms of related disorder (affective disorders, psychotic disorders, anxiety disorders, behavioral disorders, substance abuse and other disorders).

Summary Lifetime Diagnosis Checklist

Based on the previous sections, this section summarizes the course of the disorder from first episode to now.

Children’s Global Assessment Scale (C-GAS)

Scores the child’s level of functioning.

Version en español

KSADS-E
The KSADS-E, which is the epidemiological version of the KSADS, is a tool to interview parents about possible psychopathology in preschool in children. It was developed by Puig-Antich J., Orvaschel, H., Tabrizi, M.A., Chambers, W in 1980 as a structured interview. The tool examines both past and current episodes, focusing on the most severe past episode and the most current episode. However, this tool does not rate symptom severity, and should be used to assess presence or absence of symptomatology. This version of the K-SADS introduced screening questions, which, if negative, allowed skipping the remaining diagnostic probes.

WASHU-KSADS
The WASHU version of the K-SADS was written by Barbara Geller, M.D., and colleagues in 1996. It is a modified version of the KSAD-23/K-SADS1986. This version is like many other versions of the K-SADS in that it is semi-structured, administered by clinicians to both parent and child separately, and assesses present episodes. However, this version specifically expanded the mania section in order to be more applicable to pre-pubertal mania. Other modifications include a rapid cycling section, a section assessing multiple other DSM-IV diagnoses, and it examines both present and lifetime symptoms as well as symptom onset and offset items. These modifications made this specific version particularly useful for phenomenology studies.

KSADS-MRS
This version of the K-SADS is a combination/modification of the WASH-U-KSADS (Geller, MD) and the 4th revision of the KSADS-P (Joaquim Puig-Antich, M.D. and Neal Ryan, M.D.) Specifically, it assess 21 symptoms related to mood disorders, including mania, hypomania, and rapid cycling. Each item is rated on a 0-6 rating scale. Scores of 0 suggest no information is available; scores of 1 suggest the symptom is not present at al; scores of 2 suggest the symptom is slightly present; scores of 3 suggest the symptom is mildly severe; scores of 4 suggest the symptom is moderately severe; scores of 5 suggest the symptom is severe; and scores of 6 suggest the symptom is extremely severe. Items with scores of 4 or higher are clinically significant/maladaptive. Trained clinicians administer the assessment to both the child and the parent, which each provide their own separate score for each item (P and C), and the total score encompasses the sum of all of the items (S).

KSADS-L
Lifetime version

KSADS-P
Present episode

Development and history
The Schedule for Affective Disorders and Schizophrenia for School Aged Children, or K-SADS, was originally created as an adaptive version of the Schedule for Affective Disorders and Schizophrenia, a measure for adults. The K-SADS was written by Chambers, Puig-Antich, et al. in the late 1970’s. . The K-SADS was developed to promote earlier diagnosis of affective disorders and schizophrenia in children in a way that incorporates reports by both the child and parent and a “summary score” by the interviewer based on observations and teacher ratings

The first version of the K-SADS differed from other tests on children because it relied on answers to interview questions rather than observances during games and interactions. The 1990’s led to the creation of different versions of the K-SADS, each focusing on improving a specific aspect of the test, such as varying the length of the test based on answers to specific questions (K-SADS-E) or focusing less on past episodes (K-SADS-P).

Impact

 * What was the impact of this assessment? How did it affect assessment in psychiatry, psychology and health care professionals?
 * What can the assessment be used for in clinical settings? Can it be used to measure symptoms longitudinally? Developmentally?

Use in other populations
The K-SADS-PL has been written and translated into 16 different languages, as well as both Canadian English and UK English. The languages include Korean, Hebrew, Turkish, Iclandic, and Persian/Farsi. The K-SADS-PL is also available in several Indian dialects including Kannada, Marathi, Tamil and Telugu.

Research

 * Any recent research done that is pertinent?

Limitations
One limitation of the K-SADS is that it requires extensive training to give properly, including observation techniques, score calibration, and re-checks to test inter-rater reliability. Additionally, many versions of the test, including the translated versions, are not available as PDF's online.

Example page

 * General Behavior Inventory