Clinical and dynamic patterns of comorbid mental disorders in children and adolescents: acomparative prospective study

Introduction. The significance of the problem of comorbidity in child and adolescent psychiatry is due to the high incidence and insufficient knowledge of this phenomenon. Objective: to determine the prevalence and main clinical and dynamic patterns of comorbid mental disorders in children and adolescents. Materials and Methods. A cohort of 1,203 patients was prospectively followed. The number of boys (n=914; 76%) in the sample of clinical observation prevailed incomparison with girls (n=289; 24%). The average age of primary treatment was 9.39±3.66 years. Prospective follow-up wascarried out up to 18 years of age of patients. The follow-up was performed when the patients reached the age of 23-25. Theaverage follow-up period from the initial visit to a psychiatrist to 23-25 years was 11.24±4.6 years. Clinical -psychopathological, clinical-follow-up, statistical methods were used in the work. Results. Comorbid mental pathology wasregistered in almost every sixth child (17.5%). The most common types of comorbid disorders in children and adolescentswere organic mental disorders and addictions. The clinical picture of concomitant mental illnesses was characterized bypolymorphism: in 91% of cases at the time of examination, it was possible to identify the underlying disease and thecomorbid one; in 9% of cases, two or more mental illnesses simultaneously manifested themselves with the same intensity.Prospective follow-up showed that in most (79%) cases, the underlying disease remained dominant throughout the entireperiod of observation of the patient; in 9% of patients, two or more mental disorders manifested themselves simultaneouslywith the same intensity; in 12% - the underlying and comorbid diseases alternately worsened. The follow-up part of thestudy made it possible to analyze the long-term dynamics of comorbid disorders: in 80% of people, manifestations ofcomorbidity remained in adulthood; in 20%, the manifestations of the comorbid disease decreased (reduced); 77 patientsfrom the general cohort acquired certain comorbid disorders during adulthood. The presence of comorbid mental disordersnegatively affected the long-term social prognosis. Conclusion: comorbidity is a complex and widespread phenomenon inthe juvenile contingent. Reducing the incidence of comorbid pathology is impossible without preventive interventions and amultidisciplinary approach to the management of these patients.