Comorbidity in Child Psychopathology: Concepts, Issues and Research Strategies

Abstract

Abstract-Epidemiological data show that the co-occurrence of two or more supposedly separate child (and adult) psychiatric conditions far exceeds that expected by chance (clinic data cannot be used for this determination). The importance of comorbidity is shown and it is noted that it is not dealt with optimally in either DSM-III-R or IGD-9. Artifacts in the detection of comorbidity are considered in terms of referral and screening/surveiUance biases. Apparent comorbidity may also arise from various nosological considerations; these include the use of categories where dimensions might be more appropriate, overlapping diagnostic criteria, artificial subdivision of syndromes, one disorder representing an early manifestation of the other, and one disorder being part of the other. Possible explanations of true comorbidity are discussed with respect to shared and overlapping risk factors, the comorbid pattern constituting a distinct meaningful syndrome, and one disorder creating an increased risk for the other. Some possible means of investigating each of these possibilities are noted.

Comorbid psychopathology with autism spectrum disorder in children: An overview

“…Not surprisingly then, there is currently a debate on the diagnosis and conceptualization of ASDs. Therefore, issues such as whether Asperger's syndrome is a form of autism or a distinct disorder (Klin, Pauls, Schultz, & Volkmar, 2005), and whether comorbidity of psychopathology is in play for ASD are still debated (Caron & Rutter, 1991). This phenomenon is not specific to ASD however.…”

MAOA, maltreatment, and gene–environment interaction predicting children's mental health: new evidence and a meta-analysis

“…16 In childhood, the most common domains of mental health problems include antisocial behavior such as aggression and destructiveness, attention deficits, impulsivity, and hyperactivity, and emotional problems such as anxiety and social withdrawal. 17 More often than not, these domains tend to co-occur in the same child 18 and when they do, this signals greater severity of psychopathology as well as a poorer long-term prognosis. 19 Accordingly, the combination of these mental health problems in 7-year-old boys was the focus of the present investigation.…”

Differential criterion functioning of alcohol use symptomatology in major depressive disorder?

“…Although the co-morbidity between these conditions is well established, Caron & Rutter (1991) highlighted the need to distinguish between 'true ' comorbidity and artifactual co-morbidity, which may arise through a variety of processes including sample selection or referral biases and item contamination whereby similar or identical symptoms are used to form the basis of a diagnosis of multiple disorders. A further, though perhaps more subtle, issue concerns the extent to which the experience of one disorder may alter reporting of symptoms for another.…”