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Association of Internalizing Disorders and Allergies in a Child and Adolescent Psychiatry Clinical Sample

Mauricio Infante, M.D.; Marcia J. Slattery, M.D., M.H.S.; Marjorie H. Klein, Ph.D.; and Marilyn J. Essex, Ph.D.


Objective: To investigate the specificity of the association between internalizing disorders (anxiety and depression) and atopic disorders (asthma, allergic rhinitis, urticaria, and atopic dermatitis) in a child and adolescent psychiatric clinical sample.

Method: A sample of 184 youths was evaluated for current DSM-IV psychiatric disorders (clinical interview) and lifetime history of atopic disorders (parent report and chart review) in a child and adolescent psychiatry clinic from September 1, 2001, through December 31, 2002. Logistic regression analyses were used to assess the differential likelihood of having a lifetime history of atopic disorders among psychiatrically ill youths with and without internalizing disorders.

Results: Youths with internalizing disorders were significantly more likely than those with noninternalizing disorders to have a lifetime history of atopic disorders (odds ratio [OR] = 1.95, 95% CI = 1.02 to 3.73, p = .04). Moreover, analyses distinguishing youths with "pure" internalizing disorders from those with comorbid internalizing and externalizing disorders, "pure" externalizing disorders, and other psychiatric disorders showed that the association with atopic disorders was specific for "pure" internalizing disorders only (OR = 2.40, 95% CI = 1.09 to 5.30, p = .03).

Conclusions: Atopic disorders may be associated specifically with "pure" internalizing disorders in psychiatrically ill youths. Additional studies are needed to identify the underlying mechanisms of this specificity for the subsequent development of effective treatment and prevention interventions that target both disorders.

(J Clin Psychiatry 2007;68:1419-1425)


Received July 16, 2006; accepted Jan. 20, 2007. From the Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison.

Support was provided by National Institute of Mental Health grant R03-MH066073 (Dr. Slattery, principal investigator).

The authors thank John E. Huxsahl, M.D., The Mayo Clinic, Rochester, Minn., for his help with study administration. Dr. Huxsahl reports no financial affiliations or other relationships relevant to the subject of this article.

In the spirit of full disclosure and in compliance with all ACCME Essential Areas and Policies, the faculty for this CME article were asked to complete a statement regarding all relevant financial relationships between themselves or their spouse/partner and any commercial interest (i.e., a proprietary entity producing health care goods or services) occurring within at least 12 months prior to joining this activity. The CME Institute has resolved any conflicts of interest that were identified. The disclosures are as follows: The authors have no personal affiliations or financial relationships with any proprietary entity producing health care goods or services to disclose relative to the article.

Corresponding author and reprints: Marcia J. Slattery, M.D., M.H.S., Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, 6001 Research Park Blvd., Madison, WI 53719-1176 (e-mail: mslattery@wisc.edu).