1. Abstract CHADIS-DSM, a web-based questionnaire for making provisional DSM-PC diagnoses, was administered to 85 caregivers of inner city children aged 3-12 presenting for a health supervision visit and again one year later. Results indicate that mental health status was fairly stable or worsened over time if some level of dysfunction was noted at time 1, indicating that children do not outgrow these problems without intervention. These results provide the first predictive validation data for the new DSM-PC diagnoses and additional justification for pediatricians to use the DSM-PC classification system for triaging mental health problems. The AAP published the Diagnostic and Statistical manual for Primary Care (DSM-PC) (Wolraich, Ed., 1996) to help pediatricians identify mental health disorders and newly defined at-risk conditions of lesser severity: 1) developmental variation (parent is concerned but child appears to be within the normal range) and 2) problem (child has some dysfunction and some but not all criteria for a DSM-IV disorder). We developed a computerized parent questionnaire to facilitate making DSM-PC diagnoses as part of the Child Health and Development Interactive System (CHADIS). We validated CHADIS/DSM for diagnosing disorder (Sturner, Morrel, Howard, 2003a) and the new problem and variation categories (Sturner, Morrel, Howard, 2003b) compared to independent concurrent assessments. However, it is not known whether these new categories have utility in predicting later mental health morbidity. Background Caregivers of 85 children aged 3-12 years (mean=7.5) coming for health supervision visits at one of two Baltimore City clinics were administered CHADIS-DSM by a research assistant after their visit and one year later (mean=13 months, range 9-22 months). Methods Results Total scores used to represent mental health status (1 for each variation, 2 for each problem, 3 for each disorder) show remarkable stability as evidenced by a significant correlation of 0.69. Children with DSM-PC category diagnoses continue to show similar levels of morbidity one year later (e.g., all children without any initial diagnosis were free of disorder although 12% had a problem), while most children with disorder persisted with disorder and most children with an initial problem diagnosis continued in that category or worsened. The problem category was useful in documenting the persistent difficulties of the children who no longer had disorder at Time 2 and showed a positive predictive value of 0.71 for significant difficulties of either problem or disorder one year later. Conclusion This preliminary study provides the first evidence for the predictive utility of the DSM-PC categories. This provides additional justification for pediatricians to use the DSM-PC classification system for triage since children do not tend to “outgrow” the psychiatric morbidity depicted by the DSM-PC categories. DSM-PC Diagnoses Are Not “Outgrown” in One Year Raymond Sturner, MD 1,2, Barbara Howard, MD 1,2, Tanya Morrel 2 1 Johns Hopkins School of Medicine, 2 Center for Promotion of Child Development Through Primary Care References Wolraich, M. (Ed, 1996), Diagnostic and Statistical Manual for Primary Care (DSM-PC): Child and Adolescent Version, Am. Acad. Ped., Elk Grove, IL Sturner, R. A., Howard, B. J., Morrel, T., & Rogers-Senuta, K. (2003a). Validation of a Computerized Parent Questionnaire for Identifying Child Mental Health Disorders and Implementing DSM-PC. Presented at the Pediatric Academic Societies Meeting; abstract in Pediatric Research. Sturner, R. A., Howard, B. J., & Morrel, T. (2003b). Preliminary Validation of the DSM-PC. Presented at the annual meeting of the Society of Developmental-Behavioral Pediatrics. Abstract in Journal of Developmental & Behavioral Pediatrics, 393-394. Printed by Participants Objective To describe the progression of mental health status over one year in preschool and school aged children based on DSM-PC categories. Most of the children were African-American (95%), boys (53%) and receiving Medicaid (68%). Caregivers ranged in age from 18-65 (mean=33). Most were the biological parent (85%) and women (91%) with a high school diploma (44%) or some higher education (31%). Measure CHADIS-DSM is a web-based set of questions administered to parents using algorithms designed to efficiently make provisional DSM-PC diagnoses in order to ease the burden on pediatricians in evaluating the mental health problems of their patients. For this study, parents completed algorithms associated with their top 5 concerns which took an average of 12 minutes to complete (7 minutes for their top concern only). Table 1-Prediction of Mental Health Status