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It is currently debated whether specific psychiatric disorders or Internalizing versus Externalizing psychopathological dimensions are associated to Internet Addiction Disorder (IAD). We explored this issue in youth with and without IAD referred to a third-level Department of Adolescent Psychiatry during a 12-month period. All the 101 consecutively referred adolescents were assessed using categorical (Schedule for Affective Disorders and Schizophrenia for School- Age Children-K-SADS) and dimensional (Child Behavior Checklist-CBCL) measures of psychopathology, and two measures for addictive behaviors, Internet Addiction Test (IAT) (used as screening for detecting IAD patients) and Use, Abuse, Dependence on the Internet (UADI) inventory. According to an IAT cutoff score of 50, 39 patients (38.6%) presented IAD. The IAD and the no IAD groups did not differ according to age and gender. Most of the IAD patients (92.3%) endorsed multiple addictions. The IAD group had higher scores in all the UADI dimensions, except for Impact of Life. All the IAD patients endorsed psychiatric diagnoses, but only Autism Spectrum Disorders were more represented in the IAD group. According to the CBCL, patients with IAD had more social problems and anxiety symptoms. However, clusters analysis with the t-scores of the CBCL scales of Internalizing and Externalizing domains showed no differences in IAT and UADI scores among clusters. The small sample size and a selection bias (referrals for severe symptomatology) limit the generalization of the findings. Comorbidity should be systematically assessed in IAD adolescents, with categorical and dimensional measures, as it may guide personalized treatments. [ABSTRACT FROM AUTHOR]