D. O. Chalton

Performance of the Diagnostic Interview Schedule for Children Version 2.3 (DISC-2.3) in an informal settlement area in South Africa.

OBJECTIVE To investigate the performance of the Xhosa Diagnostic Interview Schedule for Children Version 2.3 (DISC-2.3) in a community study of African children and adolescents in Khayelitsha, a largely informal settlement area in Cape Town, South Africa. METHOD A cross-sectional community study of 500 youths aged 6 to 16 years was undertaken using a systematic sampling strategy based on random starting points in the community. Three trained Xhosa-speaking lay interviewers administered the DISC-2.3 to youths and their parents in their homes. Additional questions included degree of impairment, selected risk factors, and service use. RESULTS The administration of the Xhosa DISC-2.3 in an informal settlement area was both feasible and acceptable to respondents. Psychiatric disorder with impairment was recorded for 76 (15.2%) of the children and adolescents. Consultation had been sought in only 20 cases, mostly from medical doctors, except for 3 who had attended indigenous healers. Rates of disorder were significantly higher among respondents who were living in unserviced areas or who came from homes where food was needed. CONCLUSIONS The DISC is a potentially useful instrument even in the presence of major constraints on conducting epidemiological research.

Violence and Substance Use in Adolescents with Increasing Severity of Suicidal Behavior

A theoretical pathway of progression of suicidal behavior, from ideation tocommunicating suicidal intent to suicide attempt was examined by investigating whether adolescents at each stage of the pathway could be differentiated from those at the previous stage by their risk behaviors. Cluster sampling produced a sample of 7,340 high-school students who completed a self-administered questionnaire. Bivariate analyses and multivariate logistic regression models were used to investigate the relationships between stage of severity of suicidal behavior and selected risk behaviors. For females, the more severe the suicidal behaviors exhibited, the more likely that the adolescent had been both a perpetrator and victim of violence. For males, attempting suicide was associated with being a victim and perpetrator of violence. Our findings lend partial support to the continuum of severity hypothesis of suicidal behaviors and suggest that clinicians should be alerted to escalating violent behavior as a potential precursor to suicide attempt.