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Apparent comorbidity may arise as an artifact of conceptual or diagnostic models that impute inappropriate boundaries between disorders. To draw firm conclusions about comorbidity, each disorder must be clearly distinguishable from others. Few behavioral or emotional disorders of childhood have been validated as separate diagnostic entities that can be reliably distinguished from one another. Rather than accepting reports of comorbidity at face value, we need to understand how particular conceptual and diagnostic schemas affect the perceived relations among disorders. Categorical and quantitative models offer potentially complementary approaches to differentiating between disorders more effectively, a process that is essential for improving our knowledge of etiology and our assessment of the risks and benefits of particular psychopharmacological interventions.
Thomas M. Achenbach (Mon,) studied this question.