Psychiatric assessments of children and adolescents commonly incorporate reports from both youth and their caregivers. However, they may identify substantially different mental health problems, potentially influencing diagnosis, treatment planning, and estimates of psychiatric disorder prevalence.
A new study by researchers at the University of California San Diego School of Medicine and their colleagues examined the extent to which youth and caregiver reports differed across a broad range of psychiatric diagnoses from late childhood through middle adolescence. Previous studies have focused on a limited number of disorders, like depression or anxiety, at single points in time. The study was published on November 11, 2026 in JAMA Psychiatry .
The study measured how often youth and caregivers agree or disagree on psychiatric diagnoses and clinical problems, and how that agreement varies by diagnosis and developmental stage.
The research analyzed reports from 11,868 youth and their caregivers from age 9 to age 17 as part of the UC San Diego-coordinated Adolescent Brain Cognitive Development (ABCD) study, the largest long-term study of children’s brain and behavioral development in the country.
Youth and their caregivers were asked the same diagnostic questions during separate clinical interviews. The researchers derived a mental health diagnosis based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) from each youth’s own report and each caregiver’s report. They then compared those reports and tracked how much they overlapped for each diagnosis across different developmental stages.
The analysis found:
The findings highlight the importance of obtaining information directly from adolescents rather than relying exclusively on caregiver reports for adolescent psychiatric assessment, according to corresponding author Laika D. Aguinaldo, PhD, MSW, assistant professor of psychiatry at UC San Diego School of Medicine.
“Teens were more likely to disclose private, internal experiences, but parents were more likely to report more externally visible mental health problems,” she said.
The study has implications for understanding the prevalence of psychiatric disorders in young people and for clinical screening practices.
“If we're really thinking about suicidal thoughts, self-harm, substance use and sleep, most parents don't actually know that their kids are experiencing these mental health problems, which is why we need to ask both the teen and the parent,” Aguinaldo added. “If you only ask one, you might miss the opportunity to identify a young person who needs help and to intervene early.”
Future work will investigate factors associated with youth-caregiver discrepancies and whether these differences influence mental health service access and clinical outcomes.
Read the full study: “ Youth-caregiver discordance in psychiatric diagnosis and clinical problems in the ABCD study ”
JAMA Psychiatry
10.1001/jamapsychiatry.2026.3768
Youth-Caregiver Discordance in Psychiatric Diagnosis and Clinical Problems in the ABCD Study
11-Nov-2026