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Letters to the Editor
Published Online: 1 June 2007

Comorbid Disorders

William Niederhut, M.D.Authors Info & Affiliations
Publication: Psychiatric News
Volume 42, Number 11
https://doi.org/10.1176/pn.42.11.0024c
The article “Developmental Trauma Merits DSM Diagnosis, Experts Say” in the February 2 issue was excellent and raises important issues in psychiatric nosology.
Dr. Bessel van der Kolk implies that the frequent diagnosis of comorbid mood and ADHD syndromes in children and adults may often result from a failure to diagnose “complex” posttraumatic stress disorder. Fair enough. Nonetheless, there is extensive epidemiological data supporting the high incidence of inherited comorbidity of childhood-onset affective disorders and ADHD. There is also a high incidence of trauma and familial instability in bipolar families.
Before jumping on the “complex trauma” bandwagon, we should think carefully about what actually causes the observed symptoms of these complex disorders: the inherited, comorbid ADHD and affective disorder, the trauma resulting from affective dysregulation in genetically affected families, or both?

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Psychiatric News
Volume 42 • Number 11 • June 1, 2007
Pages: 24

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Published online: 1 June 2007
Published in print: June 1, 2007

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William Niederhut, M.D.
Denver, Colo.
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