Adolescent psychiatric outpatients and their caregivers: Comparing the Strengths and Difficulties Questionnaire

BACKGROUND: The use of the SDQs as a screening tool to monitor new or ongoing problems in adolescent psychiatric outpatients is needed to improve clinical outcomes. Discrepancies between parent and adolescent reports on the Strengths and Difficulties Questionnaire (SDQ), reflects the degree of emotional and behavioural symptoms. This may affect their ability to work together to reach therapeutic goals. AIM: The level of SDQ (dis)agreements between adolescent-parental self-reports in adolescent psychiatric outpatients was examined. SETTING: Weskoppies Child and Adolescent outpatients. METHODS: This two-group cross-sectional comparative study obtained SDQ responses from 74 psychiatrically diagnosed adolescents and their parents (148 completed SDQ questionnaires). Adolescent outpatients aged between 11 and 18 years following up at the outpatients between July 2017 and November 2017 were included. Adolescent and parent rating scores were compared using a paired sample t-test, and patterns of agreement were measured by using Pearson’s correlation coefficient and Cohen’s kappa. RESULTS: Parents reported more difficulties than adolescents, although differences were non-significant (p > 0.58). Caregivers and adolescents agreed on the conduct domain and on emotional symptoms (0.21 ≤ kappa ≤ 0.40, p < 0.05). Caregivers and adolescents agreed on the presentation of internalising and externalising disorders (R = 0.48, p < 0.001). CONCLUSIONS: The SDQ confirmed fair agreement between parents and adolescents. Parental perceptions of adolescent behavioural difficulties could influence parent– adolescent relations and communication. Using the SDQ as a screening tool in South Africa, requires further validation for it to be integrated as part of a multi-informant best-practice approach.