K-SADS Becomes One of the Most Widely Used Diagnostic Tools in Research and Clinical Care and Is An Example of How Our Researchers Have Contributed to Improving Assessment of Mental Health Disorders
One of the most significant contributions to the field by Department of Psychiatry investigators is the development and testing of diagnostic tools for research and clinical practice. Assessment of children and adolescents can present unique challenges. For example, mood symptoms are more challenging to evaluate in children than in adults. In 1978 the late Joachim Puig-Antich, MD, a distinguished researcher and member of the Department of Psychiatry faculty, and his colleague, William Chambers, MD, adapted the Schedule for Affective Disorders and Schizophrenia (SADS) to create the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS). The K-SADS is a semi-structured interview to measure current and past symptoms of mood, anxiety, psychotic, and disruptive behavior disorders in children ages 6-18 years old. It was designed to promote earlier diagnosis of mental disorders in children in a way that incorporates reports by both the child and parent and a clinician’s clinical judgment. . Unlike other assessment instruments for children, it relies on answers to interview questions rather than only observations during games and interactions. The K-SADS has been validated in multiple research and treatment settings.
The K-SADS instrumentation gives more flexibility to the interviewer about how to phrase and assess symptom items, while still eliciting DSM criteria. Most versions of the K-SADS also include "probes" or examples of questions that elicit symptom information. If a primary symptom w is endorsed, further questions will be asked to determine whether diagnostic criteria are met. If a primary symptom is not endorsed, additional symptoms for that disorder will not be queried.
Adaptations of the K-SADS were written by Dr. Puig-Antich and other researchers for different purposes, such as an epidemiological version, the K-SADS-E. In the 1990s, the K-SADS-PL (Present and Lifetime version) was developed and tested by Department investigators Drs. Joan Kaufman, Boris Birmaher, David Axelson, David Brent, and Neal Ryan. This version of the KSADS streamlined the prior version using screens that trigger the use of a more detailed evaluation of multiple DSM disorders including mood, anxiety schizophrenia, disruptive disorders, ADHD, obsessive compulsive disorder, bulimia, and post-traumatic stress disorder. It has been written and translated into 16 different languages, including Korean, Hebrew, Turkish, Icelandic, and Persian, is also available in several Indian dialects. More recently the KSADS was further abbreviated and modified to reflect the DSM-5. The investigators are now in the process of creating a computerized version of the instrument.
The K-SADS has become one of the most widely used diagnostic interviews in research and clinical care. It represents one of the many innovations in assessment tools that our faculty have made through their ongoing research. We invite you to visit the Resources page of Children and Adolescent Bipolar Services (CABS) website to access the newest version of the KSADS and other useful assessment instruments for children and adolescents.