Comorbidity of depression with other psychiatric disorders in adolescents: about 77 cases

##plugins.themes.academic_pro.article.main##

Imen Hadjkacem
Hela Ayadi
Adel Walha
Yosr Moalla
Farhat Ghribi

Abstract

Background: In adolescents diagnosed with depressive disorders, psychiatric comorbidity is rather the rule than the exception.
Aim: To find the prevalence of the association between depression in adolescents and other psychiatric disorders and second and to study the different mental disorders comorbid to depression.
Methods: We conducted a descriptive, retrospective and analytic survey carried on 77 subjects having been followed in the child psychiatry department of Sfax for depressive disorders diagnosed according to the DSM-IV TR criteria during a period of 9 years (from January 1st 1998 till 31st December 2006)
Results: 49.3% of the youths with depression had comorbid conditions: anxiety disorders in 23.37% of cases, disruptive disorders in 13% of cases (conduct disorders in 11.7 % of cases and oppositional defiant disorders in 1.3 % of cases), personality disorders in 13% of cases, substance abuse in 3.9% of cases and alimentary behavior disturbances in 2.6% of cases. A superimposed major depressive disorder in adolescents with dysthymia (« Double depression ») was present in 10.4 of cases.
Conclusion: Throughout our study, we underline the frequency of the association between depression in teenagers and other mental disorders. The detection of this comorbidity has a great importance as it permits to understand the pathogenesis of depression in adolescents, to examine the implications of comorbidity for course and outcomes of this disorder and to elaborate the appropriate treatment.

Keywords:

Adolescent, Comorbidity, Depressive disorder

##plugins.themes.academic_pro.article.details##

References

  1. Avenevoli S, Stolar M, Li J, Dierker L, Ries Merikangas K. Comorbidity of depression in children and adolescents: models and evidence from a prospective high-risk family study. Biol Psychiatry 2001; 49:1071-81.
  2. Essau CA. Comorbidity of depressive disorders among adolescents in community and clinical settings. Psychiatry Research 2008; 158:35-42.
  3. Karlsson L, Pelkonen M, Ruuttu T. et al. “Current comorbidity among consecutive adolescent psychiatric outpatients with DSM-IV mood disorders.” Eur. Child Adolesc. Psychiatry 2006; 10:1-13
  4. Lewinsohn PM, Rohde P, Seeley JR. Adolescent psychopathology: II. The clinical consequences of comorbidity. J Am Acad Child Adolesc Psychiatry 1995; 34:510 -19.
  5. Masi G, Millepiedi S, Mucci M, et al. Phenomenology and comorbidity of dysthymic disorder in 100 consecutively referred children and adolescents: Beyond DSM-IV. Can J Psychiatry 2003; 48:99-105.
  6. Newman D, Moffitt T, Caspi A, Silva P. Comorbid mental disorders: Implications for treatment and sample selection. J Abnorm Psychol 1998 ; 107:305?11.
  7. Rohde P, Lewinsohn PM, Seeley JR. Comorbidity of unipolar depression: II. Comorbidity with other mental disorders in adolescents and adults. . J Abnorm Psychol 1991; 100: 214- 22.
  8. Caron C, Rutter M. Comorbidity in child psychopathology: Concepts, issues and research strategies. J Child Psychol Psychiatry 1991; 32: 1063-80.
  9. Dumas JE. Les troubles de l'humeur. Psychopathologie de l'enfant et de l'adolescent. De Boeck et Larcier, 2007.
  10. Hammen C, CompasB. Unmasking unmasked depression: The problem of comorbidity in child and adolescent depression. Clin Psychol Rev 1994; 14: 585-603.
  11. Cicchetti D, Toth SL. The development of depression in children and adolescents. Am Psychol 1998; 53: 221?41.
  12. Kolvin I, Barrett ML, Bhate SR, et al. The Newcastle child depression project: Diagnosis and classification of depression. Brit J Psychiatry 1991 ;159 : 9-21.
  13. Lewinsohn PM, Rohde P, Seely JR-Adolescent psychopathology: III. The clinical consequences of comorbidity. J. Am. Acad. Child Adolesc.Psychiatry 1995, 34:510-19.
  14. Marcelli D, Berthaut E. Dépression et tentative de suicide à l'adolescence. Masson, Paris, 2001.
  15. Nottelmann ED, Jensen PS. Comorbidity of depressive disorders in children and adolescents: rates, temporal sequencing, course and outcome.In: Essau, C.A., Petermann, F. (Eds.), Depressive disorders in children and adolescents: Epidemiology, risk factors, and treatment. Jason Aronson, Northvale, NJ. 1999.
  16. Faraone SV, Biederman J, Mennin D et al. Attention deficit hyperactivity disorder with bipolar disorder: A familial subtype? J. Am. Acad. Child Adolesc. Psychiatr 1997, 36: 1378-87.
  17. Angold A, Costello EJ. Depressive comorbidity in children and adolescents: empirical, theoretical, and methodological issues. Am. J. Psychiatry 1993;150, 1779-91.
  18. Sihvola E, Rahkonen AK, Dick DM, Pulkkinen L, Rose RJ, Marttunen M. Minor depression in adolescence: Phenomenology and clinical correlates. J Affect Disord 2007; 97 : 211-18.
  19. Keller MB, Beardslee W, Lavori PW, Dorer DL, Samuelson H. Course of major depression in non referred adolescents: A retrospective study. J Affect Disord 1988 ; 15: 235- 43.
  20. Korczak DJ, Goldstein BI. Childhood Onset Major Depressive Disorder: Course of Illness and Psychiatric Comorbidity in a Community Sample. J Pediatr 2009 ; :118-23
  21. Birmaher B, Ryan ND, Williamson DE et al. Child and Adolescent Depression.: A review of the past ten years. J Am Child Adolesc Psychiatry 1996; 35:1427-39.
  22. Kovacs M, Akiskal HS, Gatsonis C, Parrone PL. Childhood- onset dysthymic disorder: clinical features and prospective naturalistic outcome. Arch Gen Psychiatry 1994, 51:365- 74.
  23. Weller EB, Weller RA. Depression in adolescents growing pains or true morbidity? J Affect Disord 61, 2000: S9-S13.
  24. Warner V, Weissman MM, Fendrich M. The course of major depression in the offspring of depressed parents: incidence, recurrence and recovery. Arch Gen Psychiatry 1992; 49, 795-801.
  25. Moffitt TE, Harrington HL, Caspi A, Cohen JK, Goldberg D, Gregory AM. Depression and Generalized Anxiety Disorder. Arch Gen Psychiatry. 2007;64:651-60.
  26. Kovacs M, Gatsonis C, Paulauskas SL, Richards C. Depressive disorders in childhood: IV. A longitudinal study of comorbidity with and risk for anxiety disorders. Arch. Gen. Psychiatry 1989; 46:776-82.
  27. Masi G, Favilla L, Mucci M. Depressive disorder in children and adolescents. Eur J Pediatr Neurology 1998; 2: 287-95.
  28. Ferro TT, Carlson GA, Grayson P, Klein DN. Depressive disorders :distinction s in children. J. Am. Acad. Child. Adolesc. Psychiatry 1994; 33:664-70.
  29. Fleming JE, Offord DR. Epidemiology of childhood depressive disorders: a critical review. J Am Acad Child Adolesc Psychiatry 1990; 29: 571-80.
  30. Bird HR, Gould MS, Staghezza B. Patterns of diagnostic comorbidity in a community sample of children aged 9 through 16 years. J Am Acad Child Adolesc Psychiatry. 1993; 32:361-68.
  31. Simic M, Fombonne E. Depressive conduct disorder: symptom patterns and correlates in referred children and adolescents. J Affect Disord 2001;62:175-85
  32. Harrington R, Fudge H, Rutter M. Adult outcomes of childhood and adolescent depression. J. Am. Acad. Child. Adolesc. Psychiatry 1991; 30:434-9.
  33. Marmorstein NR, Iacono WG. Major depression and conduct disorder in twin sample: gender, functionning, and risk for future psychopathology. J. Am. Acad. Child. Adolesc. Psychiatry. 2003;42:225-33.
  34. Toupin J, Yann Le Corff, Pauzé R . Symptomatologie et adaptation psychosociale des adolescents ayant un trouble dépressif cooccurrent à un trouble de comportement perturbateur. Rev Can Psychiatrie 2008 ; 53 :43-51.
  35. Loeber R, Burke JD, Lahey BB. What are adolescents antecedents to antisocial personality disorder? CBMH 2002; 12:24 -36.
  36. Egger H. Irritability and preschool mental health. Paper presented at: 12th Scientific Meeting of the International Society for Research in Child and Adolescent Psychopathology; New York, 2005.
  37. Marton P, Korenblum MP, Kutcher et al. Personnality dysfunction in depressed adolescents. Can J. Psychiatry 1989, 34:810-813.
  38. Akiskal HS, The prevalent clinical spectrum of bipolar disorders: Beyond DSM IV. J Clin Psychopharm 1996 ; 16 : 4S-14S.