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Encyclopedia of Adolescence pp 1–8Cite as

Comorbidity of Psychiatric Disorders

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Comorbidity refers to a person having two or more medical diseases or conditions simultaneously or over a period of time. Psychiatric comorbidity refers to the situation where these two or more conditions are mental disorders. Naturally, comorbidity exists. After all, in the same way a person could have both a broken arm and hypertension, an adolescent might meet criteria for a major depressive disorder and a specific anxiety disorder. In fact, the expected rate of comorbidity can be calculated by multiplying the prevalence rate of each disorder, thereby estimating the comorbidity rate assuming only random co-occurrence. Interestingly, psychiatric comorbidity rates, including those for children and adolescents, far exceed these base rates and follow meaningful patterns (see for instance, Merikangas et al. 2010). While some of these higher than expected comorbidity rates are likely due to conceptual errors (e.g., mistakenly thinking two disorders are distinct when they are not) or...

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References

  • Achenbach, T. M. (1966). The classification of children’s psychiatric symptoms: A factor analytic study. Psychological Monographs: General and Applied, 80, 1–37.

    Article  Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington: American Psychiatric Association.

    Google Scholar 

  • Angold, A., Costello, E. J., & Erkanli, A. (1999). Comorbidity. Journal of Child Psychology and Psychiatry, 40, 57–87.

    Article  PubMed  Google Scholar 

  • Bickman, L., Kelley, S. D., Breda, C., de Andrade, A. R., & Riemer, M. (2011). Effects of routine feedback to clinicians on mental health outcomes of youths: Results of a randomized trial. Psychiatric Services, 62(12), 1423–1429.

    Article  PubMed  Google Scholar 

  • Biederman, J., Newcorn, J., & Sprich, S. (1991). Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders. American Journal of Psychiatry, 148, 564–577.

    Article  PubMed  Google Scholar 

  • Biederman, J., Faraone, S., Mick, E., & Lelon, E. (1995). Psychiatric comorbidity among referred juveniles with major depression: Fact or artifact? Journal of the American Academy of Child and Adolescent Psychiatry, 34, 579–590.

    Article  PubMed  Google Scholar 

  • Borsboom, D., Cramer, A., Schmittmann, V. D., Epskamp, S., & Waldorp, L. J. (2011). The small world of psychopathology. PLoS ONE, 6(11), e27407.

    Article  PubMed  PubMed Central  Google Scholar 

  • Brent, D. A., Perper, J. A., Goldstein, C. E., Kolko, D. J., Allan, M. J., Allman, C. J., & Zelenak, J. P. (1988). Risk factors for adolescent suicide. A comparison of adolescent suicide victims with suicidal inpatients. Archives of General Psychiatry, 45, 581–588.

    Article  PubMed  Google Scholar 

  • Copeland, W. E., Shanahan, L., Erkanli, A., Costello, E. J., & Angold, A. (2013). Indirect comorbidity in childhood and adolescence. Frontiers in Psychiatry, 4, 144.

    Article  PubMed  PubMed Central  Google Scholar 

  • Costello, E. J., Angold, A., Burns, B. J., Stangl, D. K., Tweed, D. L., Erkanli, A., & Worthman, C. M. (1996). The great smoky mountains study of youth: Goals, designs, methods, and the prevalence of DSM-III-R disorders. Archives of General Psychiatry, 53, 1129–1136.

    Article  PubMed  Google Scholar 

  • Cramer, A., Waldorp, L. J., van der Maas, H., & Borsboom, D. (2010). Comorbidity: A network perspective. Behavioral and Brain Sciences, 33, 137–193.

    Article  PubMed  Google Scholar 

  • Eaton, N. R. (2015). Latent variable and network models of comorbidity: Toward an empirically derived nosology. Social Psychiatry and Psychiatric Epidemiology, 50, 845–849.

    Article  PubMed  Google Scholar 

  • Ehrenreich, J. T., Buzzela, B. A., Trosper, S. E., Bennett, S. M., Wright, L. A., & Barlow, D. H. (2008). Unified protocol for the treatment of emotional disorders in youth (Unpublished treatment manual). University of Miami/Boston University.

    Google Scholar 

  • Feinstein, A. R. (1970). The pre-therapeutic classification of co-morbidity in chronic disease. Journal of Chronic Diseases, 23(7), 455–468.

    Article  PubMed  Google Scholar 

  • Ford, T., Goodman, R., & Meltzer, H. (2003). The British child and adolescent mental health survey 1999: The prevalence of DSM-IV disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 1203–1211.

    Article  PubMed  Google Scholar 

  • Hyman, S. E. (2010). The diagnosis of mental disorders: The problem of reification. Annual Review of Clinical Psychology, 6, 155–179.

    Article  PubMed  Google Scholar 

  • Jensen, P. S. (2003). Comorbidity and child psychopathology: Recommendations for the next decade. Journal of Abnormal Child Psychology, 31, 293–300.

    Article  PubMed  Google Scholar 

  • Jensen, P. S., Martin, D., & Cantwell, D. P. (1997). Comorbidity in ADHD: Implications for research, practice, and DSM-V. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1065–1079.

    Article  PubMed  Google Scholar 

  • Kazdin, A. E., & Crowley, M. J. (1997). Moderators of treatment outcome in cognitively based treatment of antisocial children. Cognitive Therapy and Research, 21, 185–207.

    Article  Google Scholar 

  • Kendall, P. C., & Clarkin, J. F. (1992). Introduction to special section: Comorbidity and treatment implications. Journal of Clinical and Consulting Psychology, 60, 833–834.

    Article  Google Scholar 

  • Kessler, R., Chiu, W. T., Demler, O., & Walters, E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 617–627.

    Article  PubMed  PubMed Central  Google Scholar 

  • Krueger, R. F. (1999). The structure of common mental disorders. Archives of General Psychiatry, 56, 921–926.

    Article  PubMed  Google Scholar 

  • Krueger, R. F., & Markon, K. E. (2006). Reinterpreting comorbidity: A model-based approach to understanding and classifying psychopathology. Annual Review of Clinical Psychology, 2, 111–113.

    Article  PubMed  PubMed Central  Google Scholar 

  • Krueger, R. F., Hopwood, C. J., Wright, A. G., & Markon, K. E. (2014). DSM-5 and the path toward empirically based and clinically useful conceptualization of personality and psychopathology. Clinical Psychology: Science and Practice, 21(3), 245–261.

    Google Scholar 

  • Lonigan, C. J., Carey, M. P., & Finch, A. J., Jr. (1994). Anxiety and depression in children and adolescents: Negative affectivity and the utility of self-reports. Journal of Consulting and Clinical Psychology, 62, 1000–1008.

    Article  PubMed  Google Scholar 

  • Maj, M. (2005). “Psychiatric comorbidity”: An artifact of current diagnostic systems? The British Journal of Psychiatry, 186, 182–184.

    Article  PubMed  Google Scholar 

  • Mansell, W., Harvey, A., Watkins, E., & Shafran, R. (2009). Conceptual foundations of the transdiagnostic approach to CBT. Journal of Cognitive Psychotherapy, 23(1), 6–19.

    Article  Google Scholar 

  • Mash, R. J., & Barkley, R. A. (2003). Child psychopathology (2nd ed.). New York: Guilford Press.

    Google Scholar 

  • Merikangas, K. R., He, J. P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L.,… Swendsen, J. (2010). Lifetime prevalence of mental disorders in US adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). Journal of the American Academy of Child & Adolescent Psychiatry, 49(10), 980–989.

    Google Scholar 

  • Milberger, S., Biederman, J., Faraone, S. V., Murphy, J., & Tsuang, M. T. (1995). Attention deficit hyperactivity disorder and comorbid disorder: Issues of overlapping symptoms. American Journal of Psychiatry, 152, 1793–1799.

    Article  PubMed  Google Scholar 

  • Morey, L. C., Skodol, A. E., & Oldham, J. M. (2013). Clinician judgments of clinical utility: A comparison of DSM-IV-TR personality disorders and the alternative model for DSM-5 personality disorders. Journal of Abnormal Psychology, 123, 398–405.

    Article  Google Scholar 

  • MTA Cooperative Group. (1999). A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. Archives of General Psychiatry, 56, 1073–1086.

    Article  Google Scholar 

  • Orimoto, T. E., Mueller, C. W., Hayashi, K., & Nakamura, B. J. (2014). Community-based treatment for youth with co-and multimorbid disruptive behavior disorders. Administration and Policy in Mental Health and Mental Health Services Research, 41(2), 262–275.

    Article  PubMed  Google Scholar 

  • Simonoff, E., Pickles, A., Meyer, J. M., Silberg, J. L., Maes, H. H., Loeber, R., … Eaves, L. J. (1997). The Virginia Twin study of adolescent behavioral development: Influences of age, sex and impairment on rates of disorder. Archives of General Psychiatry, 54, 801–808.

    Google Scholar 

  • Waschbusch, D. A. (2002). A meta-analytic examination of comorbid hyperactive–impulsive–attention problems and conduct problems. Psychological Bulletin, 128, 118–150.

    Article  PubMed  Google Scholar 

  • Weisz, J., & Chorpita, B. (2012). Mod squad for youth psychotherapy: Restructuring evidence-based treatment for clinical practice. In P. Kendall (Ed.), Child and adolescent therapy: Cognitive-behavioral procedures (4th ed.). New York: Guilford.

    Google Scholar 

  • Wells, A. (2007). The attentional training technique: Theory, effects and a metacognitive hypothesis on auditory hallucinations. Cognitive and Behavioral Practice, 14, 134–138.

    Article  Google Scholar 

  • Winfree, M. R. (2014). Does the squeaky wheel get the grease? Therapy targets for youth with comorbid internalizing and externalizing diagnoses. Unpublished master’s thesis, Honolulu, University of Hawaii at Manoa.

    Google Scholar 

  • World Health Organization. (1997). Multiaxial presentation of the ICD-10 for use in adult psychiatry. New York: Cambridge University Press.

    Book  Google Scholar 

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Authors and Affiliations

  1. Department of Psychology, University of Hawai‘i at Mānoa, Honolulu, HI, 96822, USA

    Daniel P. Wilkie, Trina E. Orimoto, Kristiann D. S. Miyamoto, Henri-Lee Stalk & Charles W. Mueller

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  1. Daniel P. Wilkie
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  2. Trina E. Orimoto
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  3. Kristiann D. S. Miyamoto
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  4. Henri-Lee Stalk
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  5. Charles W. Mueller
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Correspondence to Daniel P. Wilkie .

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Editors and Affiliations

  1. Indiana University, Bloomington, Indiana, USA

    Roger J.R. Levesque

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Wilkie, D.P., Orimoto, T.E., Miyamoto, K.D.S., Stalk, HL., Mueller, C.W. (2016). Comorbidity of Psychiatric Disorders. In: Levesque, R. (eds) Encyclopedia of Adolescence. Springer, Cham. https://doi.org/10.1007/978-3-319-32132-5_198-2

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  • DOI: https://doi.org/10.1007/978-3-319-32132-5_198-2

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