The Concept of Comorbidity in Psychiatry and Its Influence on Research of Risk Factors

  • T. Bronisch

Abstract

Comorbidity refers to the joint occurrence of two illnesses. Its use originated in general medicine and medical epidemiology (Feinstein 1970). Applied to mental disorders, the term refers to the joint occurrence of two or more mental disorders and/or with medical conditions. Comorbidity can take place during an episode of illness for the individual; within the lifetime of an individual; and among members of larger groups, such as patients, the general population, and families (Klerman 1990).

Keywords

Depression Europe Schizophrenia Neurol Agoraphobia 

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References

  1. American Psychiatric Association (1980) Diagnostic and statistical manual. Mental disorders, 3rd edn. DSM-III. Am Psychiatr Assoc, WashingtonGoogle Scholar
  2. American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders. Revised version (DSM-III-R). Am Psychiatr Assoc, WashingtonGoogle Scholar
  3. Boyd JH, Burke jr JD, Grünberg E, Holzer CE, Rae DS, George LK, Karno M, Stoltzman R, McEvoy L, Nestadt G (1984) Exclusion criteria of DSM-III: a study of co-occurrence of hierarchy-free syndromes. Arch Gen Psychiatry 41: 983–988PubMedCrossRefGoogle Scholar
  4. Bronisch T, Hecht H (1989) Validity of adjustment disorder, comparison with major depression. J Affect Dis 17: 229–236PubMedCrossRefGoogle Scholar
  5. Bronisch T, Hecht H (1990) Major depression with and without a coexisting anxiety disorder: social dysfunction, social integration, and personality features. J Affect Dis 20: 151–157PubMedCrossRefGoogle Scholar
  6. Clare A, Cairns V (1978) Design, development and use of a standardized interview to assess social maladjustment and dysfunction in community studies. Psychol Med 8: 589–604PubMedCrossRefGoogle Scholar
  7. Coryell W, Endicott J, Andreasen NC, Keller MB, Clayton PJ, Hirschfeld RMA, Scheftner WA, Winokur G (1988) Depression and panic attacks: the significance of overlap as reflected in follow-up and family study data. Am J Psychiatry 145: 293–300PubMedGoogle Scholar
  8. Endicott J, Spitzer RL (1978) A diagnostic interview. The schedule for affective disorders and schizophrenia. Arch Gen Psychiatry 35: 837–844PubMedCrossRefGoogle Scholar
  9. Eysenck HJ (1947) Dimensions of personality. Routledge & Kegan Paul, LondonGoogle Scholar
  10. Faltermaier T, Wittchen H-U, Ellmann R, Lässle R (1985) The social interview schedule (SIS) — content, structure and reliability. Soc Psychiatry 20: 115–124PubMedCrossRefGoogle Scholar
  11. Feinstein AR (1970) The pre-therapeutic classification of comorbidity in chronic disease. J Chron Dis 21: 455–468CrossRefGoogle Scholar
  12. Hecht H, Faltermaier T, Wittchen H-U (1987) Social interview schedule (SIS). Ein Verfahren zur Beschreibung sozialer und sozialpsychologischer Faktoren der Lebenssituation. Roderer, RegensburgGoogle Scholar
  13. Hecht H, Wittchen H-U (1988) The frequency of social dysfunction in a general population sample and in patients with mental disorders: a comparison using the social interview schedule (SIS). Soc Psychiatry Psychiatr Epidemiol 23: 17–29PubMedCrossRefGoogle Scholar
  14. Hirschfeld RMA, Klermann GL, Clayton PJ, Keller MB, McDonald-Scott P, Larkin BH (1983) Assessing personality: effects of the depressive state on trait measurement. Am J Psychiatry 140: 695–699PubMedGoogle Scholar
  15. Klerman GL (1990) Approaches to the phenomena of co-morbidity. In: Mases JD, Cloninger CR (eds) Co-morbidity of mood and anxiety disorders. American Psychiatric, Washington, DC, pp 13–37Google Scholar
  16. Leekman JF, Weissman MM, Merikangas KR, Pauls DL, Prusoff BA (1983) Panic disorder and major depression. Increased risk of depression, alcoholism, panic, and phobic disorders in families of depressed probands with panic disorder. Arch Gen Psychiatry 40: 1055–1060CrossRefGoogle Scholar
  17. Moore H, Kleining G (1960) Das soziale Selbstbild der Gesellschaftsschichten in Deutschland. Kölner Z Soziol Sozialpsychol 12: 86–119Google Scholar
  18. Robins LN, Helzer JE, Croughan J, Ratcliff KS (1981) National Institute of Mental Health, Diagnostic Interview Schedule: its history, characteristics and validity. Arch Gen Psychiatry 38: 381–389PubMedCrossRefGoogle Scholar
  19. Robins LN, Helzer JE, Weissman MM, Orvaschel H, Gruenberg E, Burke JD, Regier DA (1984) Lifetime prevalence of specific psychiatric disorders in three sites. Arch Gen Psychiatry 41: 949–958PubMedCrossRefGoogle Scholar
  20. Semler G, Wittchen H-U (1983) Das Diagnostik-Interview-Schedule. Erste Ergebnisse zur Reliabilität und differentiellen Validität der deutschen Fassung. In: Kommer D, Röhrle B (eds) Gemeindepsychologische Perspektiven 3. GwG, Cologne. DGVT, Tübingen, pp 109–117Google Scholar
  21. Slater E, Slater P (1944) A heuristic theory of neurosis. J Neurol Psychiatry 7: 49–55PubMedCrossRefGoogle Scholar
  22. Spitzer RL, Williams JB, Gibbon M (1986) Structured Clinical Interview for DSM-III-R patient version (SCID-P, 8/1/86). Biometric Research Department, New York State Psychiatric Institute, New YorkGoogle Scholar
  23. Sturt E (1981) Hierarchical patterns in the distribution of psychiatric symptoms. Psychol Med 11: 783–794PubMedCrossRefGoogle Scholar
  24. Surtees PG (1980) Social support, residual adversity and depressive outcome. Soc Psychiatry 15: 71–80CrossRefGoogle Scholar
  25. VanValkenburg C, Akiskal HS, Puzantian V, Rosenthal T (1984) Anxious depressions: clinical family history, and naturalistic outcome-comparisons with panic and major depressive disorders. J Affective Disorders 6: 67–82CrossRefGoogle Scholar
  26. Von Zerssen D, Pfister H, Köller D-M (1988) The Munich Personality Test (MPT): a short questionnaire for self-rating and relatives’ rating of personality traits: formal properties and clinical potential. Eur Arch Psychiatr Neurol Sci 238: 73–93Google Scholar
  27. Wing JK, Cooper JE, Sartorius N (1974) Measurement and classification of psychiatric symptoms. Cambridge University Press, CambridgeGoogle Scholar
  28. Wittchen H-U, Hecht H, Zaudig M, Vogl G, Semler G, Pfister H (1988) Häufigkeit und Schwere psychischer Störungen in der Bevölkerung Eine epidemiologische Feldstudie. In: Wittchen H-U, von Zerssen D (eds) Verläufe behandelter und unbehandelter Depressionen und Angststörungen. Springer, Berlin, Heidelberg, New York, pp 232–251Google Scholar
  29. Wittchen H-U, Rupp H-U (1982) Diagnostic interview schedule. Dt. Version II. Max-Planck Institut für Psychiatrie (unpublished data)Google Scholar
  30. Wittchen H-U, von Zerssen D (1988) Verläufe behandelter und unbehandelter Depressionen und Angststörungen. Springer, Berlin, Heidelberg, New YorkGoogle Scholar
  31. World Health Organization (WHO) (1965) Manual of the international statistical classification of diseases, injuries and causes of death. Sect 5, 8th rev. World Health Organization, GenevaGoogle Scholar
  32. World Health Organization (WHO) (1979) Manual of the international statistical classification of diseases, injuries and causes of death. Sect 5, 9th rev. World Health Organization, GenevaGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1992

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  • T. Bronisch

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