Members of the ARCH Lab recently published a paper in Children (Basel) titled “Internalizing-Externalizing Comorbidity and Impaired Functioning in Children”. The objective of this exploratory study was to examine whether internalizing-externalizing comorbidity was associated with impaired functioning in children currently receiving mental health services. Data come from the Multimorbidity in Youth Receiving Mental Health Services study.

Internalizing disorders are characterized by distress directed inwards – for example major depressive disorder and anxiety disorders. Externalizing disorders are characterized by distress directed toward the individual’s environment or toward others – for example ADHD or oppositional defiant disorder.

Authors found that internalizing-externalizing comorbidity in children was associated with worse functioning compared to children with strictly internalizing comorbidities. Other factors that impacted this relationship were parent’s psychological distress and distance to the pediatric hospital; both were associated with worse functioning in children.

Health professionals should be mindful that children with internalizing-externalizing comorbidity may experience worsening functioning that is disruptive to daily activities and should use this information when making decisions about care.