TABLE 2

Associations of DSM-IV Indices of Mental Disorders and Physical Conditions Among Youth in Pediatric Services

Physical Conditionsa and RatingnCGAS ≤70bMental Disordersc,d
AnxietyADHDBehaviorMoodSubclinical Psychosis Symptoms
%aOR (95% CI)%aOR (95% CI)%aOR (95% CI)%aOR (95% CI)%aOR (95% CI)%aOR (95% CI)
Allergy/immunology
 Severe allergies
  None/mild893223.3Ref11.7Ref17.5Ref18.2Ref12.3Ref21.4Ref
  Mod/severe8228.01.14 (0.68–1.91)13.40.99 (0.50–1.97)24.41.44 (0.81–2.55)15.90.65 (0.33–1.29)20.72.17 (1.17–4.03)20.70.78 (0.42–1.42)
 Asthma/respiratory
  None/mild891023.3Ref11.8Ref17.6Ref18.3Ref12.4Ref21.5Ref
  Mod/severe10423.10.79 (0.48–1.31)3.80.29 (0.10–0.83)14.40.85 (0.47–1.56)8.70.51 (0.23–1.10)11.51.36 (0.70–2.66)11.50.53 (0.27–1.02)
 Autoimmune/ inflammatory
  None/mild821323.4Ref11.6Ref17.6Ref18.5Ref12.0Ref21.6Ref
  Mod/severe80123.11.02 (0.85–1.24)12.91.05 (0.82–1.34)16.71.05 (0.84–1.31)15.21.00 (0.80–1.27)17.01.39 (1.11–1.75)*18.50.87 (0.71–1.08)
Cardiology
 None/mild870023.2Ref11.7Ref17.7Ref18.4Ref12.4Ref21.4Ref
 Mod/severe31427.71.05 (0.79–1.38)10.20.78 (0.52–1.17)13.70.69 (0.48–0.99)13.40.87 (0.60–1.26)14.01.16 (0.81–1.67)21.01.08 (0.79–1.47)
Endocrine/metabolic
 None/mild846323.3Ref11.7Ref17.6Ref18.2Ref12.4Ref21.5Ref
 Mod/severe55124.71.03 (0.83–1.28)12.01.04 (0.78–1.39)17.10.98 (0.76–1.28)17.61.17 (0.90–1.52)13.10.87 (0.65–1.17)19.60.95 (0.75–1.21)
Eye/ear/nose/throat
 None/mild871823.1Ref11.6Ref17.3Ref18.1Ref12.5Ref21.2Ref
 Mod/severe29631.11.23 (0.93–1.62)14.21.23 (0.86–1.76)24.31.22 (0.89–1.67)22.01.32 (0.95–1.82)10.10.56 (0.37–0.86)27.41.35 (1.01–1.81)
Gastroenterology
 None/mild839423.3Ref11.7Ref17.5Ref18.4Ref12.3Ref21.6Ref
 Mod/severe62023.41.03 (0.83–1.27)11.91.09 (0.83–1.45)18.21.17 (0.92–1.51)15.30.99 (0.76–1.28)14.20.99 (0.75–1.30)17.90.89 (0.70–1.14)
Hematology
 None/mild866023.3Ref11.6Ref17.6Ref18.1Ref12.4Ref21.1Ref
 Mod/severe35425.10.92 (0.70–1.19)13.81.15 (0.82–1.63)15.50.74 (0.53–1.03)20.31.01 (0.74–1.37)13.30.93 (0.65–1.33)28.21.32 (1.01–1.73)
Nephrology/urology
 None/mild878023.2Ref11.6Ref17.6Ref18.2Ref12.2Ref21.4Ref
 Mod/severe23428.21.14 (0.83–1.55)13.20.93 (0.61–1.42)17.50.98 (0.66–1.45)17.11.01 (0.68–1.49)19.71.57 (1.08–2.29)20.90.89 (0.62–1.28)
Neurology
 Birth anomalies
  None/mild766622.4Ref11.4Ref17.2Ref18.4Ref12.5Ref20.9Ref
  Mod/severe134828.41.21 (1.04–1.40)13.21.16 (0.94–1.41)19.40.89 (0.74–1.06)16.80.88 (0.73–1.06)11.70.85 (0.68–1.05)24.01.24 (1.05–1.46)
 CNS
  None/mild724820.8Ref11.116.2Ref17.7Ref11.3Ref20.2Ref
  Mod/severe176633.61.60 (1.42–1.81)***14.01.10 (0.93–1.30)23.01.32 (1.14–1.53)**20.20.96 (0.82–1.12)16.91.30 (1.10–1.53)*26.31.20 (1.05–1.37)
 Developmental
  None/mild739518.7Ref10.913.0Ref15.6Ref12.2Ref18.5Ref
  Mod/severe161944.73.34 (2.95–3.76)***15.21.16 (0.97–1.39)38.43.12 (2.72–3.58)***29.81.51 (1.30–1.75)***13.50.76 (0.63–0.92)*34.31.73 (1.50–1.98)***
Oncology
 None/mild873123.5Ref11.8Ref17.7Ref18.3Ref12.4Ref21.4Ref
 Mod/severe28319.10.79 (0.57–1.08)7.40.64 (0.40–1.03)12.40.75 (0.50–1.11)14.11.01 (0.70–1.47)12.01.04 (0.70–1.55)19.11.08 (0.77–1.49)
Orthopedics
 None/mild830023.2Ref11.6Ref17.5Ref18.5Ref12.1Ref21.5Ref
 Mod/severe71425.20.96 (0.79–1.16)12.91.04 (0.81–1.35)18.61.09 (0.87–1.38)14.60.82 (0.64–1.06)15.71.27 (0.99–1.62)19.30.84 (0.67–1.04)
  • N = 9014. ***P < .0001, **P < .01, *P < .05 (FDR adjusted). DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; mod, moderate; Ref, reference.

  • a Physical conditions based on electronic medical chart review and parent informant report (or proband report for youth aged ≥18 y).

  • b aORs based on logistic regression models simultaneously controlling for gender, age, race/ethnicity, maternal education, and other physical disorders shown in the table (not adjusted for mental disorders).

  • c Diagnosis algorithms for DSM-IV indices of mental disorders considered endorsement of screen question, symptom count, duration, distress, and impairment. Anxiety = agoraphobia, generalized anxiety disorder, panic disorder, separation anxiety disorder; Behavior = oppositional defiant disorder, conduct disorder; Mood = major depressive disorder and mania; subclinical psychosis symptoms were based on subpsychotic positive symptoms (PRIME-Screen Revised), subthreshold negative/disorganized symptoms (6 SIPS ratings), and/or positive psychosis screen.

  • d aORs based on logistic regression models simultaneously controlling for gender, age, race/ethnicity, maternal education, other DSM-IV indices of mental disorders, and other physical disorders shown in the table (not adjusted for CGAS score).