Adolescent Psychopathology: III. The Clinical Consequences of Comorbidity

doi:10.1097/00004583-199504000-00018

Journal of the American Academy of Child & Adolescent Psychiatry

Volume 34, Issue 4, April 1995, Pages 510-519

https://doi.org/10.1097/00004583-199504000-00018 Get rights and content

ABSTRACT

Objective

To describe the clinical consequences associated with the lifetime occurrence of comorbid psychiatric disorders.

Method

In a community sample of 1,507 older adolescents (aged 14 through 18 years), subjects with “pure” and comorbid forms of four major psychiatric disorders (depression, anxiety, substance use, and disruptive behavior) were compared on six clinical outcome measures.

Results

The impact of comorbidity was strongest for academic problems, mental health treatment utilization, and past suicide attempts; intermediate on measures of role functioning and conflict with parents; and nonsignificant on physical symptoms. The greatest incremental impact of comorbidity was on anxiety disorders; the least was on substance use disorders. Although some patterns of comorbidity were much more common in boys (e.g., substance use and disruptive behavior disorder) or in girls (e.g., depression and anxiety), the impact of specific comorbid disorders on the clinical measures was not different for females and males. The effect of comorbidity was not due to current psychopathology.

Conclusions

The significance of comorbidity differs across specific comorbid disorders and across outcome measures, with some comorbid disorders being much more detrimental, and some outcome measures much more affected, than others.

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: This research was supported in part by NIMH awards MH40501 and MF50522. We gratefully acknowledge the assistance of Ian Gotlib and the two anonymous reviewers for their comments on a draft of this article.

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SPECIAL ARTICLEAdolescent Psychopathology: III. The Clinical Consequences of Comorbidity

ABSTRACT

Objective

Method

Results

Conclusions

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Affect Disord

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Affect Disord

J Am Acad Child Adolesc Psychiatry

J. Am Acad Child Psychiatry

Diagnostic and Statistical Manual of Mental Disorders, 3rd edition-revised (DSM-III-R)

Health and Ways of Living: The Alameda County Study

Comorbidity of attention-deficit hyperactivity disorder (ADHD) with conduct, depressive, anxiety and other disorders

Am J Psychiatry

Comorbidity of anxiety and depression in children and adolescents

Psychol Bull

Comorbidity in child psychopathology

J Child Psychol Psychiatry

A coefficient of agreement for nominal scales

Educ Psychol Meas

Depression and panic attacks

Am J Psychiatry

Adolescent depression, alcohol and drug use

Am J Public Health

SPECIAL ARTICLE
Adolescent Psychopathology: III. The Clinical Consequences of Comorbidity