title: Comorbidity of physical and mental disorders in the neurodevelopmental genomics cohort study.
abstract: OBJECTIVE
  To examine patterns of associations between a broad range of mental and physical conditions by using a large, systematically obtained pediatric registry.
  
  
  METHODS
  The sample included 9014 youth ages 8 to 21 years (4349 males and 4665 females; 3585 aged <13 years, 3678 aged 13 to 18 years, and 1751 aged 19 to 21 years) from the Philadelphia Neurodevelopmental Cohort identified through pediatric clinics at the Children's Hospital of Philadelphia health care network by the Center for Applied Genomics. Measures were as follows: physical condition based on electronic medical records and interview data on 42 physical conditions of 14 organ systems/specialties and mental disorders based on an abbreviated version of the structured Kiddie-Schedule for Affective Disorders and Schizophrenia psychiatric diagnostic interview.
  
  
  RESULTS
  There was a direct association between the severity of the physical condition and most classes of mental disorders, as well as with functional impairment. Models adjusted for sociodemographic correlates, other physical and mental disorders, and false discovery and revealed broad patterns of associations between neurodevelopmental disorders with behavior disorders (odds ratio [OR]: 1.5; 95% confidence interval [CI]: 1.3-1.8; P < .004) and attention-deficit/hyperactivity disorder (OR: 3.1; 95% CI: 2.7-3.6; P < .0001), and neurologic/central nervous system conditions (OR: 1.3; 95% CI: 1.1-1.9; P < .05) with mood disorders and attention-deficit/hyperactivity disorder (OR: 1.3; 95% CI: 1.1-1.5; P < .001), and autoimmune/inflammatory conditions with mood disorders (OR: 1.4; 95% CI: 1.1-1.8, P < .05).
  
  
  CONCLUSIONS
  Findings show the strong overlap between physical and mental conditions and their impact on severity and functional impairment in youth. Specific patterns of comorbidity have important implications for etiology. Prospective tracking of cross-disorder morbidity will be important to establish more effective mechanisms for prevention and intervention.
authors.affiliation: Genetic Epidemiology Research Branch, Division of Intramural Research Program, and merikank@mail.nih.gov.
authors.forename: Kathleen R
authors.initials: KR
authors.lastname: Merikangas
authors.affiliation: Neuropsychiatry Section and Brain Behavior Laboratory and.
authors.forename: Monica E
authors.initials: ME
authors.lastname: Calkins
authors.affiliation: Genetic Epidemiology Research Branch, Division of Intramural Research Program, and.
authors.forename: Marcy
authors.initials: M
authors.lastname: Burstein
authors.affiliation: Genetic Epidemiology Research Branch, Division of Intramural Research Program, and.
authors.forename: Jian-Ping
authors.initials: JP
authors.lastname: He
authors.affiliation: The Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and.
authors.forename: Rosetta
authors.initials: R
authors.lastname: Chiavacci
authors.affiliation: Genetic Epidemiology Research Branch, Division of Intramural Research Program, and Department of Neurology, Children's National Medical Center, Washington, District of Columbia.
authors.forename: Tarannum
authors.initials: T
authors.lastname: Lateef
authors.affiliation: Neuropsychiatry Section and Brain Behavior Laboratory and.
authors.forename: Kosha
authors.initials: K
authors.lastname: Ruparel
authors.affiliation: Neuropsychiatry Section and Brain Behavior Laboratory and.
authors.forename: Ruben C
authors.initials: RC
authors.lastname: Gur
authors.affiliation: Translational Genomics Branch, National Institute of Mental Health, Bethesda, Maryland;
authors.forename: Thomas
authors.initials: T
authors.lastname: Lehner
authors.affiliation: The Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania;
authors.forename: Hakon
authors.initials: H
authors.lastname: Hakonarson
authors.affiliation: Neuropsychiatry Section and Brain Behavior Laboratory and.
authors.forename: Raquel E
authors.initials: RE
authors.lastname: Gur
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology / Q000235:genetics; D001327:Autoimmune Diseases / Q000453:epidemiology / Q000235:genetics; D002493:Central Nervous System Diseases / Q000453:epidemiology* / Q000235:genetics*; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology / Q000235:genetics; D002908:Chronic Disease / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D002658:Developmental Disabilities / Q000453:epidemiology* / Q000235:genetics*; D004185:Disability Evaluation; D005260:Female; D023281:Genomics; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000235:genetics*; D019964:Mood Disorders / Q000453:epidemiology / Q000235:genetics; D015143:Philadelphia; D012042:Registries; D013223:Statistics as Topic; D055815:Young Adult
keywords: comorbidity; mental disorders; physical disorders; registry; youth