What is Comorbidity? Copy
Comorbidity refers to the presence of independent psychiatric disorders. They may be present during the same period of time (concurrent comorbidity), or that are present, but not necessarily overlapping, during one’s life (lifetime comorbidity) (i.e., simultaneous or sequential disorders).
The possible relationships between two disorders may take various forms:
Comorbidity of disorders may also reflect methodological artifacts due to limitations of the diagnostic system. There are over 350 diagnoses in the DSM-IV, many of which have overlapping clinical features. In fact, the marked incidence of comorbid disorders raises questions about whether the diagnoses in DSM-IV are indeed discrete and separate entities.
Common comorbid conditions seen in early psychosis include anxiety disorders, mood disturbance and substance-related disorders. Comorbid conditions should be identified early on and assessed for regularly throughout the course of treatment (as it is very possible that they will emerge later on in recovery from psychosis). Treatments for comorbid conditions should be the evidence-based treatments that would be used for those conditions if they existed as the sole disorder. However, there is a growing consensus that use of an integrated therapy approach represents the most viable strategy for assisting young people with comorbid conditions. The core clinical interventions must be evidence-based while adhering to the client’s value system and needs rather than representing a dogmatic or singular approach to recovery. Some non-traditional therapies such as group work, peer support, and exercise may be viable adjuncts – these are areas that have not received as much research but reports from young individuals with psychosis suggest they may result in significant benefits.
- One disorder may regularly precede the development of the other disorder, thus the first disorder may be a risk factor or precipitant for the second;
- The two disorders co-occur and may be manifestations of the same disorder or both disorders may be caused by the same underlying factors (i.e., both disorders have a common etiology) and thus represent different manifestations or stages of the same disorder;
- One disorder may modify the presentation of another disorder (e.g., mental retardation and depression, addictive and mental disorders);
- One disorder may complicate certain disorders (e.g., the presence of Axis III medical conditions);