Comorbidity of depressive disorders among adolescents in community and clinical settings.

The aim of this article was to examine the comorbidity rates and clinical characteristics of depressive disorders among adolescents in community and clinical settings, using the same methodology. One thousand and thirty-five adolescents from the community setting and 200 adolescents from the clinical setting were interviewed using the computerized Munich version of the Composite International Diagnostic Interview. In both settings, the comorbidity of depressive disorders with other psychiatric disorders was high. About 58% of the depressed adolescents in the community setting had at least one additional disorder, compared with 63.5% in the clinical setting. The most common comorbid pattern was that of depressive and anxiety disorders. Among adolescents with anxiety and depression, 72% and 62% of those in the community and clinical settings, respectively, reported the occurrence of anxiety before that of depression. Depressed adolescents with comorbid disorders used significantly more mental health services than adolescents with depression only. The findings suggest the need to design assessment and intervention strategies to deal with adolescents with multiple disorders.