Comorbidity

Abstract

We review recent research on the prevalence, causes, and effects of diagnostic comorbidity among the most common groups of child and adolescent psychiatric disorders; anxiety disorders, depressive disorders, attention deficit hyperactivity disorders, oppositional defiant and conduct disorders, and substance abuse. A meta-analysis of representative general population studies provides estimates of the strength of associations between pairs of disorders with narrower confidence intervals than have previously been available. Current evidence convincingly eliminates methodological factors as a major cause of comorbidity. We review the implications of comorbidity for understanding the development of psychopathology and for nosology.

Understanding Linkages Among Mixture Models

“…Many syndromes share symptoms (including oppositional defiant and conduct disorder syndromes, generalized anxiety and depression syndromes, and oppositional defiant and depression syndromes). When studying longitudinal associations among psychiatric syndromes, overlapping symptoms can be a methodological confound if unaccounted for (see Angold, Costello, & Erkanli, 1999;. Overlapping symptoms could induce acrossprocess local dependence among outcomes in a conventional parallel-process LTA.…”

Pathways from maternal depressive symptoms to adolescent depressive symptoms: the unique contribution of irritability symptoms

“…depression) and externalizing disorders (e.g. conduct disorder, and callous‐unemotional traits) (Angold, Costello, & Erkanli, 1999; Loeber, Green, Keenan, & Lahey, 1995; Maughan, Rowe, Messer, Goodman, & Meltzer, 2004). Partly due to the fact that Oppositional Defiant Disorder (ODD) predicts to such a wide range of adjustment difficulties in children, the DSM 5 (American Psychiatric Association, 2013) has suggested a distinction among irritable, headstrong, and hurtful ODD dimensions, as these dimensions appear to associate with distinct outcomes.…”

Prevalence of DSM-IV Disorder in a Representative, Healthy Birth Cohort at School Entry: Sociodemographic Risks and Social Adaptation

“…23 Moreover, the belief that comorbidity reflects lack of differentiation of psychiatric symptoms in young children has been dispelled. 24 Historically, children's disorders have been grouped into two domains: internalizing, which includes anxiety and depressive disorders and symptoms; and externalizing, which includes disruptive behavior and attention/hyperactivity disorders and symptoms.…”

“…24 Historically, children's disorders have been grouped into two domains: internalizing, which includes anxiety and depressive disorders and symptoms; and externalizing, which includes disruptive behavior and attention/hyperactivity disorders and symptoms. 7 Comorbidity prevalence has been addressed in several ways, counting as comorbid children with the following: more than one psychiatric disorder, irrespective of type; more than one disorder within a specific domain, or “homotypic comorbidity;” and disorders across the internalizing/externalizing boundary, or “heterotypic comorbidity.” 23 Children with comorbid psychiatric disorders are more likely to persist and to be more impaired; 23 therefore, estimating comorbidity rates during the transition to school can inform service need.…”