The interrater reliability of DSM III in children

A total of 195 admissions to a child psychiatric inpatient unit were diagosed independently by two to four clinicians on the basis of case presentations at the first wardround after admission. The DSM HI as a whole and the major categories were of high or acceptable reliability, though a few were clearly unreliable. The results are generally consistent with other studies. Unlike other studies, the subcategories were examined and found to vary widely in reliability both as a whole across the system and within parent major categories, throwing considerable doubt upon their utility. The results indicate the need both for improved diagnostic datagathering techniques in child psychiatry and for more betterdesigned studies of reliability and, most necessarily, of validity.