Resumen

GORDILLO, Rodolfo; DEL BARRIO, Victoria  y  CARRASCO, Miguel Angel. Longitudinal analysis of comorbidity between depression and aggression: Chronicity and severity in individuals 11 to 13 years. Interdisciplinaria [online]. 2012, vol.29, n.1, pp.165-185. ISSN 1668-7027.

The comorbidity between depression and aggression in children and adolescents is an issue that has sparked controversy as its existence has important implications for the validity of the classification systems, for the establishment of explanatory models, the design of new treatments as well as in the final outcome which the comorbid person presents in these in comparison with conventional treatments. In addition, the prevalence rates in depressive-aggressive comorbidity are significant, oscillating between 7.97 and 10.91%. Therefore, the study of comorbidity becomes necessary and the lack of studies focusing on the subject comes as a surprise. Perhaps one of the main problems concerning the research of comorbidity lies in the fact that most of the studies do not validate the clinical criteria that focuses on the principle of synergy, as Clark and Watson had established in Tripartite model, since doing so would require longitudinal studies measuring the effects of a commorbid disorder in contrast to those where there is no comorbidity to be found. In addition to clinical judgment, the Tripartite model demands a further statistic indicating the existence of a significant correlation between those synergistic disorders, which is the one on which most studies have been focusing. This type of results, based solely on clinical judgment, mainly through cross-sectional studies, has not allowed to implement another type of results, as suggested by the Tripartite model, that would have helped to establish clinical and diagnostic criteria through dimensional self-assessment tools which are closer to a reality in child and adolescent assessment where comorbidity is rather the rule than the exception. Therefore, that kind of study, using a longitudinal design over a period of three years, will help expand those cross-sectional ones, which will allow for examining whether there is a significant association, as well as a synergy that attests to the existence of an aggressive-depressive comorbidity on both, statistical and clinical level. In order to do so this study examined the severity and chronicity of a group of comorbid depressive-aggressive persons. In addition, the levels of depression and aggression and the role of sex within these relationships were analyzed. The sample, randomly selected from different schools in the Community of Madrid (Spain), comprised 525 individuals ranging from 11 to 13 years old, 58.9% female, the family structure was mostly biparental (92%) and the vast majority belonged to a middle class environment (85%). Depression and aggression were assessed through specific types of self-report questionnaires for children and adolescents, both in their Spanish version. The results support the statistical basis, since depression and aggression exhibit a significant positive and moderate association ranging between .11 and .24, in which the fact that the found association was higher within verbal aggression than in the physical one among all ages with the exception of the group of subjects to testing aged 12 needs to be stressed. With regards to the clinical criteria, the results provide partial support, as comorbid subjects exhibit a longer duration in chronic aggressive symptoms than those other groups affected only by depression or aggression, while they are similar to those of merely depressive subjects in the symptoms indicating a depression. Regarding severity, comorbid subjects show a higher level within the field of totally and verbally aggressive symptoms, as well as in the depressive ones which makes their physical aggression comparable to the one found in the test group of total aggression, hence, the data partially support the clinical standard. The tested person's sex, however, is of no significant meaning for the outcome. In conclusion, the data indicates the importance of exploring the comorbidity of different types of aggression, particularly the verbal one, and within different age groups. The need for addressing the underlying primary disorder symptoms in long-term affected patients is discussed, since chronic comorbidity may underlie the expression of one of the disorders and entail important implications for diagnosis and treatment.

Palabras clave : Comorbidity; Depression; Aggression physical and verbal; Child; Adolescent.

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