Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #118465

Ann Vander Stoep, PhD¹, Elizabeth McCauley, PhD¹, Jerald R. Herting, PhD², and David Stewart, PhD³. (1) Child Health Institute, University of Washington, Box 354920, Seattle, WA 98195, 206-543-1538, annv@u.washington.edu, (2) Psychosocial and Community Health, University of Washington, Health Sciences, Box 357263, Seattle, WA 98195-7263, (3) Graduate Psychology Program, Seattle Pacific University, 3307 3rd Ave West, Suite 107, Seattle, WA 98119

Co-morbid psychiatric conditions are common in young people and adversely affect their development. This paper explores the meaning of concurrent co-morbidity between depressive and disruptive behavior in early adolescence. The Developmental Pathways Project (DPP) has conducted universal screening of 1,500 11-12 year old Seattle public school students for signs of depression and disruptive behavior. On the basis of screening scores, 450 students were randomly selected from four strata: co-morbid, high depression only, high disruptive only, and low depression and disruptive. The cohort of 450 students and their parents were interviewed five times between ages 11-14 years. We use both cross-sectional and longitudinal data to examine the extent to which co-morbid depression and disruption in early adolescence is explained by overlapping symptoms, severity of psychopathology, and/or a core psychopathological process.[1]

A series of analyses show that 1) Overlapping symptoms (e.g., irritability, mood lability, lack of concentration) explains 1/3-1/2 of the co-morbidity observed; 2) Co-morbidity is a marker for severity, as co-morbid adolescents have more depressive symptoms, more disruptive symptoms, and greater impairment than those who score high on only one dimension of psychopathology; and 3) At this age co-morbidity also represents a underlying core process reflected in general distress or “negative affectivity”.

Understanding the meanings of co-morbidity can inform questions of nosology, phenomenology, and etiology and can help in designing effective programs for early identification, prevention, and treatment of childhood emotional distress, disorder, and disability. Such understanding is of great public health importance.

Learning Objectives:

• 1. Become familiar with different forms of psychiatric morbidity.
• 2. Learn the prevalence of co-occurring and non-co-occurring depression and disruptive behavior problems in early adolescence.
• 3. Consider how co-morbidity reflects overlapping symptoms, severe psychopathological states, and non-specific manifestations of psychopathology in childhood.
• 4. Discuss implications of co-morbidity and the meaning of co-morbidity for treatment and prevention of childhood mental health conditions.

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.