PSYCHIATRIC COMORBIDITY & STRUCTURAL BRAIN FEATURES IN THE ADOLESCENT BRAIN AND COGNITIVE DEVELOPMENT STUDY COHORT: A CROSS-SECTIONAL US POPULATION-BASED STUDY

Background Children who develop a psychiatric disorder often also develop additional comorbid psychiatric conditions, ultimately impacting prognosis, outcomes, and treatment planning. In this cross-sectional study using the ABCD dataset, the authors set out to identify distinct comorbidity profiles using comorbidity network analysis and any associated clinical correlates of behavior and structural neuroimaging markers. Methods Structural magnetic resonance imaging and psychometric testing were obtained from 7077 eligible children between the ages of 9-10 in the ABCD dataset. Children were separated into the typically developing group and the psychiatric group based on the presence of a DSM-V diagnosis. Results Three comorbidity profiles across gender emerged using comorbidity network analysis. Girls with the ADHD – ODD (AO) comorbidity profile and sparse comorbidity profile had thicker left superior frontal gyri compared to typically developing children. Boys and girls with the ADHD – ODD comorbidity profile had significantly higher externalizing scores compared to typically developing children. The ADHD-OCD-Specific Phobia (AOS) profile among boys had significantly higher internalizing scores, while the AO profile had significantly higher internalizing scores for girls. The AOS profile for boys and the AO profile for girls had significantly higher total problem scores compared to typically developing children. Conclusion Comorbidity network analysis successfully identified comorbidity profiles associated with unique neurobiological markers and behavioral correlates and is a feasible technique for the investigation of comorbid psychiatric conditions. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Data used in the preparation of this article were obtained from the Adolescent Brain Cognitive DevelopmentSM (ABCD) Study (), held in the NIMH Data Archive (NDA). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors