The DOI matches its Crossref record; 68 of the 70 references it cites were found in a registry or an index.
Comorbidity in Child Psychopathology: Concepts, Issues and Research Strategies
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 ICD-9. Artifacts in the detection of comorbidity are considered in terms of referral and screening/surveillance 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.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Citations
Cites
Education, health, and behaviour
Rutter, M. E. (1970) · Medical Entomology and Zoology · Cited by 3,236
Self-citationPsychopharmacology: The third generation of progress
O’Connell, R. A. (1988) · Comprehensive Psychiatry · doi:10.1016/0010-440x(88)90057-0 · Cited by 3,020
International Classification of Diseases
Jones, F. A. (1978) · Gut · doi:10.1136/gut.19.12.1175 · Cited by 2,919
Psychopharmacology: The Third Generation of Progress.
(1988) · Annals of Internal Medicine · doi:10.7326/0003-4819-108-3-509_2 · Cited by 2,021
Limitations of the Application of Fourfold Table Analysis to Hospital Data
Berkson, J. (1946) · Biometrics Bulletin · doi:10.2307/3002000 · Cited by 1,810 · cited 3×
“In that connection, it should be noted that, whenever less than all subjects with disorder are referred, clinic samples will always contain a disproportionately large proportion of patients showing comorbidity (Berkson, 1946).”
BackgroundInfluentialAnxiety and Its Disorders: The Nature and Treatment of Anxiety and Panic
Otto, M. (1989) · Psychosomatics · doi:10.1016/s0033-3182(89)72285-4 · Cited by 1,581
DSM-III Disorders in Preadolescent Children
Anderson, J. C. (1987) · Archives of General Psychiatry · doi:10.1001/archpsyc.1987.01800130081010 · Cited by 1,466
Kohnstamm, G. A., Bates, J. E., & Rothbart, M. K. (1989) · Medical Entomology and Zoology · Cited by 1,299
Freeman, H. E., & Robins, L. N. (1967) · American Sociological Review · doi:10.2307/2091752 · Cited by 1,221
Avison, W. R., Brown, G. W., & Harris, T. (1990) · Contemporary Sociology A Journal of Reviews · doi:10.2307/2072630 · Cited by 1,148
Development and risk factors of juvenile antisocial behavior and delinquency
Loeber, R. (1990) · Clinical Psychology Review · doi:10.1016/0272-7358(90)90105-j · Cited by 1,032
Sturdy childhood predictors of adult antisocial behaviour: replications from longitudinal studies
Robins, L. N. (1978) · Psychological Medicine · doi:10.1017/s0033291700018821 · Cited by 999
McCord, W. (1967) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-196707000-00012 · Cited by 930
Parental psychiatric disorder: effects on children
Rutter, M. L., & Quinton, D. (1984) · Psychological Medicine · doi:10.1017/s0033291700019838 · Cited by 824
Self-citationEstimnates of the Prevalence of Childhood Maladjustment in a Community Survey in Puerto Rico
Bird, H. (1988) · Archives of General Psychiatry · doi:10.1001/archpsyc.1988.01800360068010 · Cited by 716
Straight and Devious Pathways From Childhood to Adulthood
Weissman, M. M. (1991) · American Journal of Psychiatry · doi:10.1176/ajp.148.10.1392-a · Cited by 691
Obsessive Compulsive Disorder in Adolescence: An Epidemiological Study
FLAMENT, M. F., WHITAKER, A., RAPOPORT, J. L., DAVIES, M., BERG, C. Z., KALIKOW, K., SCEERY, W., & SHAFFER, D. (1988) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-198811000-00018 · Cited by 684
Juvenile Delinquency: Trends and Perspectives.
Holton, J. K., Rutter, M. L., & Giller, H. (1985) · Contemporary Sociology A Journal of Reviews · doi:10.2307/2069175 · Cited by 619
Self-citationPersonality and compatibility: A prospective analysis of marital stability and marital satisfaction.
Kelly, E. L., & Conley, J. J. (1987) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.52.1.27 · Cited by 612
Weissman, M. M. (1987) · Archives of General Psychiatry · doi:10.1001/archpsyc.1987.01800220009002 · Cited by 574
Boyd, J. H. (1984) · Archives of General Psychiatry · doi:10.1001/archpsyc.1984.01790210065008 · Cited by 543
Pre-school to School: a Behavioural Study
Sturge, J. C. (1983) · Archives of Disease in Childhood · doi:10.1136/adc.58.5.398-a · Cited by 453
Psychiatric Disorders in Pediatric Primary Care
Costello, E. J. (1988) · Archives of General Psychiatry · doi:10.1001/archpsyc.1988.01800360055008 · Cited by 451
Isle of Wight Revisited: Twenty-five Years of Child Psychiatric Epidemiology
Rutter, M. L. (1989) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-198909000-00001 · Cited by 427
Self-citationPersonality and compatibility: A prospective analysis of marital stability and marital satisfaction.
Kelly, E. L., & Conley, J. J. (1987) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.52.1.27 · Cited by 400
Comorbidity of substance abuse and other psychiatric disorders in adolescents
Bukstein, O. G., Brent, D. A., & Kaminer, Y. (1989) · American Journal of Psychiatry · doi:10.1176/ajp.146.9.1131 · Cited by 384
Development of Antisocial and Prosocial Behavior: Research, Theories, and Issues
Rutter, M. L., Olweus, D., Block, J., & Radke‐Yarrow, M. (1988) · Contemporary Sociology A Journal of Reviews · doi:10.2307/2070637 · Cited by 379
Self-citationMajor Depression and Conduct Disorder in Prepuberty
Puig-Antich, J. (1982) · Journal of the American Academy of Child Psychiatry · doi:10.1016/s0002-7138(09)60910-9 · Cited by 377
Kashani, J. H., Beck, N. C., Hoeper, E. W., Fallahi, C., Corcoran, C. M., McAllister, J. A., Rosenberg, T. K., & Reid, J. C. (1987) · American Journal of Psychiatry · doi:10.1176/ajp.144.5.584 · Cited by 365
Pre-school to school: A behavioural study.
Richman, N., Stevenson, J. L., & Graham, P. J. (1982) · Academic Press eBooks · Cited by 298
Effect of Anxiety on Cognition, Behavior, and Stimulant Response in ADHD
PLISZKA, S. R. (1989) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-198911000-00012 · Cited by 293 · cited 1×
“Taylor et ai (1987) showed that the benefits were not evident when the system pattern included marked anxiety; and Pliszka (1989) found that children with ADHD comorbid with anxiety had no significant benefit from methylphenidate in a double blind control trial (whereas those without anxiety showed…”
BackgroundAssessment and Diagnosis in Child Psychopathology
Kourany, R. F. C. (1989) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-198907000-00034 · Cited by 278
Imipramine in Prepubertal Major Depressive Disorders
Puig-Antich, J. (1987) · Archives of General Psychiatry · doi:10.1001/archpsyc.1987.01800130093012 · Cited by 277
Adult Outcomes of Childhood and Adolescent Depression: II. Links with Antisocial Disorders
Harrington, R., Fudge, H., Rutter, M. L., Pickles, A. R., & Hill, J. (1991) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199105000-00013 · Cited by 274
Self-citationA Controlled Family History Study of Prepubertal Major Depressive Disorder
Puig-Antich, J. (1989) · Archives of General Psychiatry · doi:10.1001/archpsyc.1989.01810050020005 · Cited by 271
Familial Transmission of Depression and Alcoholism
Merikangas, K. R. (1985) · Archives of General Psychiatry · doi:10.1001/archpsyc.1985.01790270057006 · Cited by 262
Genetic Factors in Child Psychiatric Disorders—II. Empirical Findings
Rutter, M. L., Macdonald, H., Couteur, A. S. L., Harrington, R., Bolton, P., & Bailey, A. J. (1990) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1990.tb02273.x · Cited by 241
Self-citationADDH and Conduct Disorder: Degree of Diagnostic Overlap and Differences among Correlates
Szatmári, P., Boyle, M., & Offord, D. R. (1989) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-198911000-00010 · Cited by 224
The Role of Diagnosis in Psychiatry
DAVIS, J. A. (1976) · American Journal of Psychiatry · doi:10.1176/ajp.133.5.596 · Cited by 218
Taylor, E. A., Schachar, R. J., Thorley, G., Wieselberg, H. M., Everitt, B. J., & Rutter, M. L. (1987) · Psychological Medicine · doi:10.1017/s0033291700013039 · Cited by 210
Self-citationDepression in an Adolescent Delinquent Population
Chiles, J. A. (1980) · Archives of General Psychiatry · doi:10.1001/archpsyc.1980.01780230097015 · Cited by 207
Psychosocial Functioning in Prepubertal Major Depressive Disorders
Puig-Antich, J. (1985) · Archives of General Psychiatry · doi:10.1001/archpsyc.1985.01790280093010 · Cited by 196
Rand, C. S. W., & Kuldau, J. M. (1990) · International Journal of Eating Disorders · doi:10.1002/1098-108x(199005)9:3 · Cited by 195
Meehan, M. C. (1963) · JAMA · doi:10.1001/jama.1963.03060030080046 · Cited by 188
Conduct problems as predictors of substance abuse.
Robins, L. N., & McEvoy, L. R. (1990) · Cited by 182
Last, C. G., Hersen, M., Kazdin, A. E., FINKELSTEIN, R., & Strauss, C. C. (1987) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-198707000-00011 · Cited by 178
Anorexia nervosa: a study of 34 twin pairs and one set of triplets
Holland, A. J., Hall, A., Murray, R., Russell, G. F. M., & Crisp, A. H. (1984) · British Journal of Psychiatry · doi:10.1192/bjp.145.4.414 · Cited by 174
Child and Adolescent Psychiatry. Modern Approaches
Robson, K. S., & Lewis, M. (1986) · Journal of the American Academy of Child Psychiatry · doi:10.1016/s0002-7138(09)60273-9 · Cited by 159
Prevention of Mental Disorders, Alcohol and Other Drug Use in Children and Adolescents
Gonzales, J. J. (1990) · Psychosomatics · doi:10.1016/s0033-3182(90)72148-2 · Cited by 156
Childhood behaviour and mental health
Shepherd, M. A., Oppenheim, A. N., & Mitchell, S. (1971) · University of London Press eBooks · Cited by 138
Meyerian psychobiology, personality development, and the role of life experiences
Rutter, M. L. (1986) · American Journal of Psychiatry · doi:10.1176/ajp.143.9.1077 · Cited by 132
Self-citationImipramine in adolescent major depression: plasma level and clinical response
Ryan, N. D., Puig-Antich, J., Cooper, T. B., RABINOVICH, H., Ambrosini, P. J., Davies, M., King, J., TORRES, D., & Fried, J. (1986) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1986.tb02686.x · Cited by 130
Parental concordance for affective disorders: psychopathology in offspring
Merikangas, K. R., Prusoff, B. A., & Weissman, M. M. (1988) · Journal of Affective Disorders · doi:10.1016/0165-0327(88)90025-0 · Cited by 127
Relatives at risk for mental disorder
Holland, A. J. (1990) · Behaviour Research and Therapy · doi:10.1016/0005-7967(90)90092-w · Cited by 124
READING RETARDATION AND ANTISOCIAL BEHAVIOUR
Sturge, C. (1982) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1982.tb00046.x · Cited by 109
LIFE EXPERIENCES, DEVELOPMENT AND CHILDHOOD PSYCHOPATHOLOGY
Goodyer, I. M. (1991) · Clinical Psychology Forum · doi:10.53841/bpscpf.1991.1.33.44 · Cited by 78
Delineating the boundaries of social phobia: Its relationship to panic disorder and agoraphobia
Mannuzza, S., Fyer, A. J., Liebowitz, M. R., & Klein, D. F. (1990) · Journal of Anxiety Disorders · doi:10.1016/0887-6185(90)90023-3 · Cited by 72
Starfield, B. H. (1974) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.1974.02110310144038 · Cited by 62
Applying Impairment Criteria to Children's Psychiatric Diagnosis
Weissman, M. M., Warner, V., & Fendrich, M. (1990) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199009000-00019 · Cited by 60
The efficiency of two-phase designs in prevalence surverys of mental disorders
Newman, S. C., Shrout, P. E., & Bland, R. C. (1990) · Psychological Medicine · doi:10.1017/s0033291700013362 · Cited by 59
Comparison of DISC with Clinicians' DSM-III Diagnoses in Psychiatric Inpatients
Weinstein, S. R., Stone, K., Noam, G. G., GRIMES, K., & Schwab‐Stone, M. (1989) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-198901000-00010 · Cited by 57
Recommendations for Research on Disruptive Behavior Disorders of Childhood and Adolescence
Loeber, R., & Lahey, B. B. (1989) · Springer eBooks · doi:10.1007/978-1-4613-9832-5_9 · Cited by 37
Child and Adolescent Psychiatric Disorders in DSM-IV: Issues Facing the Work Group
Shaffer, D., Campbell, M., Cantwell, D. P., Bradley, S. J., Carlson, G. A., Cohen, D. J., DENCKLA, M. B., FRANCES, A. J., Garfinkel, B. D., KLEIN, R. G., et al. (1989) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-198911000-00003 · Cited by 36
The relationship between social vulnerability and the occurrence of severely threatening life events
Champion, L. (1990) · Psychological Medicine · doi:10.1017/s0033291700013337 · Cited by 24
SCHOOL PERFORMANCE, IQ AND DELINQUENCY
Offord, D. R., Poushinsky, M. F., & SULLIVAN, K. (1978) · The British Journal of Criminology · doi:10.1093/oxfordjournals.bjc.a046885 · Cited by 22
Pfeffer, C. R., & Plutchik, R. (1989) · Comprehensive Psychiatry · doi:10.1016/0010-440x(89)90051-5 · Cited by 16
Grayson, D. A., Bridges, K. W., Cook, D. J., & Goldberg, D. P. (1990) · Psychological Medicine · doi:10.1017/s0033291700013386 · Cited by 15
Low Plasma Selenium in Down's Syndrome (Trisomy 21)
Sinet, P., Nève, J., Nicole, A., & Molle, L. (1984) · Acta Paediatrica · doi:10.1111/j.1651-2227.1984.tb09945.x · Cited by 10
Research works printed but not linked: 9
- American Psychiatric Association, 1987, Diagnostic and statistical manual of mental disorders (DSM‐III)
- Kashani J. H., 1987, Psychiatric disorders in a community sample of adolescents, American Journal of Psychiatry, 144, 584
- Robins L. N., 1990, Straight and devious pathways from childhood to adulthood, 182
- Rutter M., 1970, Education, health and behavior
- Shaffer D., 1985, Child and adolescent psychiatry: modern approaches, 465
- Strober M., A controlled family study of anorexia nervosa: evidence of familial aggregation and lack of shared transmission with affective disorders, International Journal of Eating Disorders.
- Taylor E., 1988, Assessment and diagnosis in child psychopathology, 377
- World Health Organization, 1990, Clinical Descriptions and Diagnostic Guidelines
- Yule W., 1985, Child and adolescent psychiatry: modern approaches, 444
Cited by
Sorted by citations
Merikangas, K. R., He, J.-P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., Benjet, C., Georgiades, K., & Swendsen, J. (2010) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2010.05.017 · Cited by 6,278
Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., & Baird, G. (2008) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/chi.0b013e318179964f · Cited by 3,399
The p Factor: One General Psychopathology Factor in the Structure of Psychiatric Disorders?
Caspi, A., Houts, R. M., Belsky, D. W., Goldman-Mellor, S. J., Harrington, H., Israel, S., Meier, M. H., Ramrakha, S., Shalev, I., Poulton, R., et al. (2014) · Clinical Psychological Science · doi:10.1177/2167702613497473 · Cited by 2,449
McLean, C. P., Asnaani, A., Litz, B. T., & Hofmann, S. G. (2011) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2011.03.006 · Cited by 2,519
Rose, A. J., & Rudolph, K. D. (2006) · Psychological Bulletin · doi:10.1037/0033-2909.132.1.98 · Cited by 2,517
Metadata
- Authors
- Caron, C., & Rutter, M.
- Affiliations
- Medical Research Council (GB)
- Corresponding author
- Caron, Chantal
- ORCID
- Rutter, Michael
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 1991-11
- Volume
- 32
- Issue
- 7
- Pages
- 1063-1080
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- OpenAlex
- W2120208194
- Cited by
- 1,051
- References
- 70
- Citations by year
- 2026: 7 · 2025: 11 · 2024: 13 · 2023: 17 · 2022: 17 · 2021: 13 · 2020: 22 · 2019: 14 · 2018: 10 · 2017: 25 · 2016: 28 · 2015: 35 · 2014: 33 · 2013: 34 · 2012: 46
- FWCI
- 6.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- comorbidities, child psychopathology, psychiatric diagnosis, DSM-III-R, ICD-9, diagnostic criteria, referral bias, screening bias, disease classification, dimensional models, shared risk factors
- MeSH terms
- Adult, Age Factors, Mental Disorders, Child, Child Psychiatry, Humans, Research Design, Risk Factors, Comorbidity
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review