Stability and Natural History of DSM-III Childhood Diagnoses

Follow-up or natural history outcome data for various DSM-III child and adolescent psychiatric diagnoses are presented. The data are relevant not only to our understanding of the specific disorders but also to the validity of the DSM-III diagnostic categories. "Semi-blind" psychiatric evaluations of 151 children were made as they presented to a community speech/language clinic and again approximately 4 years later. The follow-up data revealed high stability for only three diagnoses: infantile autism, attention deficit disorder with hyperactivity, and oppositional disorder. The data revealed that several of the DSM-III subcategories lacked predictive validity. This was true for the distinctions between attention deficit disorder with versus without hyperactivity; and between avoidant, separation anxiety, and overanxious disorders. Surprisingly low stability was found for conduct disorder diagnoses as were surprisingly poor prognoses for parent-child problems and adjustment disorders.