Dr. S Brian Hood

In this chapter the authors provide a discussion of the very difficult concept of comorbidity in child and adolescent psychiatric diagnosis. Comorbidity can imply deficits with the diagnostic system including but not limited to unrealistic diagnostic criteria. This issue is central to many debates about child and adolescent psychiatric diagnosis. The authors use ADHD as a disorder which exemplifies comorbidities. They emphasize potential ethical consequences of comorbidity related to polypharmacy and the classification system.

Anybody who has some familiarity with the research literature in scientific psychology has probably thought, at one time or another, ‘Well, all these means and correlations are very interesting, but what do they have to do with me, as an individual person?’. The question, innocuous as it may seem, is a deep and complicated one. In contrast to the natural sciences, where researchers can safely assume that, say, all electrons are exchangeable save properties such as location and momentum, people differ from each other. Furthermore, it is not obvious that these differences can be treated as irrelevant to the structure of the organisms in question, i.e., it is not clear that they can be treated as ‘noise’ or ‘error’. The problem permeates virtually every subdiscipline of psychology, and in fact may be one of the reasons that progress in psychology has been limited. As Lykken (1991, pp. 3–4) hypothesizes: