Symptomatology and Family Functioning in Children and Adolescents with Comorbid Anxiety and Depression

Objective: Previous studies suggest that comorbid anxiety and depressive disorders in youth are associated with more severe symptomatology and family dysfunction than either disorder alone. Our aim was to replicate and extend past findings by expanding the definition of comorbidity to include comorbid subthreshold symptoms (i.e., symptoms fall below the diagnostic criteria cut-off of a disorder). Method: A clinic-based sample of 193 youth (aged 4-18) and maternal caregivers completed measures assessing the youth's internalizing symptoms and family functioning. Results: Comorbid youth endorsed more severe anxiety symptoms and family dysfunction than anxiety-only youth. By contrast, comorbid youth did not endorse more severe depression symptoms or family dysfunction compared to youth with depression only. Similar results were found for maternal reports of internalizing symptoms, but maternal reports of family functioning yielded no group differences. Conclusions: This study replicates past findings that the presence of comorbid depression in anxious youth is associated with severe anxiety and family dysfunction. Our findings also suggest that subthreshold depressive symptoms in anxious youth relate to the severity of symptomatology and family dysfunction reported, but subthreshold anxiety symptoms in depressed youth do not. Longitudinal studies are needed to further clarify the etiology and developmental course of this comorbidity.