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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Cam W. on May 23, 2001, at 12:36:46
Dr.Ryan - You had mentioned that some depressed children develop a conduct disorder in the course of their depressive disorder. Is this a true comorbidity or is the conduct disorder a somatic complaint and effect of the depression (ie. is the conduct disorder due to the result aberrant coping mechanisms as a result of the depression)? I know that comorbid disorders often have a common link (eg. anxiety and depression, bipolar disorder and substance abuse). Do you think that this is what is going on in this instance?
Thank you for your time and the presentation. - Cam W.
Posted by Dr. Bob on June 12, 2001, at 8:02:34
In reply to RYAN - Comorbidity, posted by Cam W. on May 23, 2001, at 12:36:46
There is quite a bit written about the different mechanisms that could account for comorbidity and my assumption is that in many cases several such mechanisms may be in play to explain a particular comorbidity. In this case, my "guess" is as you outline -- during the depression the social skills of the child deteriorate with the irritability that is a symptom of the depression, with the relative lack of social pleasure, etc., and so some children sort of "tip over" into having enough conduct symptoms to be diagnosed with that disorder, too. In those cases the conduct disorder improves with improvement in the depression. All this, however, is my clinical guess and not based on controlled studies.
Posted by Cam W. on June 12, 2001, at 22:50:35
In reply to Re: from Dr. Ryan: Comorbidity, posted by Dr. Bob on June 12, 2001, at 8:02:34
Dr.B - Give my thanks to Dr.Ryan. - Cam
Posted by Noa on June 22, 2001, at 16:07:07
In reply to Re: from Dr. Ryan: Comorbidity » Dr. Bob, posted by Cam W. on June 12, 2001, at 22:50:35
Another thought I have is: anxious kids often develop oppositional behavior--at least at home with parents(anxiety leads to reluctance for certain activities, need for predictibility, not dealing well with changes in routine, etc.). If the oppositional behavior becomes habitual, or it engenders power struggles which only escalate the oppositionality, it can reach the level of oppositional-defiant disorder. In turn, a kid with ODD, habitually oppositional, really entrenched in power struggles with adults in several aspects of his or her life could develop conduct problems.
This is the end of the thread.
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