Zusammenfassung
Allgemein beschreibt der Begriff Komorbidität den Umstand, daß viele Patienten mehr als eine Diagnose aufweisen. Akiskal (1990) wies kürzlich darauf hin, daß dieses Phänomen bereits seit der Antike gut bekannt ist (»Patients with anxiety of long standing are subject to melancholia«, Aristoteles, Epidemics III). Auch im klinischen Alltag finden wir in ausführlicheren Krankengeschichten und Verhaltensanalysen oft Hinweise wieder, die unter dem Phänomen der Komorbidität zusammengefaßt werden können, wie Angaben zu Haupt- und Nebendiagnosen, zu Persönlichkeitsstörungen sowie zu körperlichen Erkrankungen. Der Begriff Komorbidität wurde allerdings im englischen Sprachraum erst durch Feinstein (1970) populär, der Komorbidität definierte als »any distinct additional clinical entity that has existed and that may occur during the clinical course of a patient who has the index disease under study« (S. 456–457).
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Literatur
Akiskal, H.S. (1990). Toward a clinical understanding of the relationship of anxiety and depressive disorders. In J.D. Maser, C.R. Cloninger (Eds.), Comorbidity of mood and anxiety disorders (pp. 597–610). Washington/DC: American Psychiatric Press.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington/DC: Author.
Angst, J. & Dobler-Mikola, A. (1985). The Zurich study — V. Anxiety and phobia in young adults. European Archives of Psychiatry and Neurological Sciences, 234, 408–418.
Blazer, D.G., Hughes, D., George, L.K., Swartz, M. & Boyer, R. (1991). Generalized Anxiety Disorder. In L.N. Robins & D.A. Regier (Eds.), Psychiatric disorders in America. The epidemiologic catchment area study (pp. 180–203). New York: The Free Press.
Boyd, J.F. (1986). Use of mental healt services for the treatment of panic disorder. American Journal of Psychiatry, 143, 1569–1574.
Breier, A., Charney, D.S. & Heninger, G.R. (1986). Agoraphobia with panic attacks. Development, diagnostic stability, and course of illness. Archives of General Psychiatry, 43, 1029–1036.
Bronisch, T. & Hecht, H. (1990). Major depression with and without a coexisting anxiety disorder: Social dysfunction, social integration, and personality features. Journal of Affective Disorders, 20, 151–157.
Burke, J. D., Wittchen, H.-U., Regier, D.A. & Sartorius, N. (1990). Extracting information from diagnostic interviews on co-occurrence of symptoms of anxiety and depression. In J. D. Maser & C.R. Cloninger (Eds.), Comorbidity of mood and anxiety disorders (pp. 649–667). Washington/DC: American Psychiatric Press.
Coryell, W., Noyes, R. & Clancy, J. (1982). Excess mortality in PD: a comparison with primary unipolar depression. Archives of General Psychiatry, 39, 701.
Eaton, W.W., Dryman, A. & Weissman, M.M. (1991). Panic and Phobia. In L.N. Robins & D.A. Regier (Eds.), Psychiatric disorders in America. The epidemiologic catchment area study (pp. 155–179). New York: The Free Press.
Eaton, W. W., Kessler, R.C., Wittchen, H.-U. & Magee, W.J. (1994). Panic and panic disorders in the United States. American Journal of Psychiatry, 151, 413–420.
Faravelli, C. & Albanesi, G. (1987). Agoraphobia with panic attacks: 1 year prospective follow-up. Comprehensive Psychiatry, 28, 481–487.
Feinstein, A. R. (1970). The pre-therapeutic classification of co-morbidity in chronic disease. Journal of Chronic Diseases, 23, 455–468.
Fiester, S. J., Ellison, J.M., Dochert, J. P. (1990). Comorbidity of personality disorders: two for the price of three. In Treating personality — new direction for mental health (pp. 103–114). New York: Jossey-Bass.
Hecht, H., Zerssen, D. von, Krieg, C., Pössl, J. & Wittchen, H.-U. (1989). Anxiety and depression: comorbidity, psychopathology and social functioning. Comprehensive Psychiatry, 30, 420–433.
Karno, M. & Golding, J.M. (1991). Obsessive-compulsive disorder. In L.N. Robins & D.A. Regier (Eds.). Psychiatric disorders in America. The epidemiologic catchment area study (pp. 204–219) New York: The Free Press.
Kessler, R.C., McGonagle, K. A., Leaf, P. J., Frank, R., Zhao, S., Nelson, C.B., Hughes, M., Wittchen, H.-U., Kendler, K. S. & Edlung, M. (in press). Psychiatric disorders in the US: prevalence, impairment and frequency of treatment. New England Journal of Medicine.
Kessler, R. C., McGonagle, K. A., Zhao, S., Nelson, C.B., Hughes, M., Eshleman, S., Wittchen, H.-U. & Kendler, K. S. (1994). Lifetime and 12-month prevalence of DSMIII-R psychiatric disorders in the United States: Results from the national comorbidity survey. Archives of General Psychiatry, 51, 8–19.
Klein, D. F. (1981). Anxiety reconceptualized. In D. F. Klein & J. G. Rabkin (Eds.). Anxiety: New research and changing concepts. New York: Raven.
Klerman, G.L. (1990). Approaches to the phenomena of comorbidity. In J. D. Maser & C.R. Clonbiger (Eds.), Comorbdity of mood and anxiety disorders (pp. 13–40). Washington/DC: American Psychiatric Press.
Lepine, J.P., Wittchen, H.U. & Essau, C.A. (1993). Lifetime and current comorbidity of anxiety and depressive disorders: Results from the international WHO/ADAMHA CIDI field trials. International Journal of Methods in Psychiatric Research, 3, (2), 67–78.
Lesser, I.M., Rubin, R. T., Pecknold, J.C., Rifkin, A., Swinson, R. P., Lydiard, R.B., Burrows, G.D., Noyes, R. Jr. & DuPont, R. L. Jr. (1988), Secondary depression in panic disorder and agoraphobia. Archives of General Psychiatry, 45, 437–443.
Liberthson, R., Sheehan, D. V., King, M.E. & Weyman, A.E. (1986). The prevalence of mitral valve prolapse in patients with panic disorders. American Journal of Psychiatry, 143, 511.
Magee, W. J., Eaton, W. W., Wittchen, H.-U., McGonagle, K. A. & Kessler, R.C. (in press) Agoraphobia, simple phobia, and social phobia in the national comorbidity survey. Archives of General Psychiatry.
Margraf, J. & Ehlers, A. (1988). Panic attacks in non-clinical subjects. In I. Hand & H.-U. Wittchen (Eds.), Panic and phobias. Heidelberg: Springer.
Markowitz, J. S., Weissman, M. M., Quellette, R., Lish, J. & Klerman, G.L. (1989). Quality of life in panic disorder. Archives of General Psychiatry, 46, 984–992.
Maser, J. D. & Cloninger, C. R. (Eds.). (1990). Comorbidity of mood and anxiety disorders. Washington/DC: American Psychiatric Press.
Mavissakalian, M. & Hamann, M. S. (1987). DSM-III personality disorder in agoraphobia II. changes to treatment. Comprehensive Psychiatry, 28, 356–361.
Medalie, J. H. & Goldbourt, U. (1976). Angina pectoris among io.000 men. II Psychosocial and other risk factors as evidenced by a multivariate analysis of a five year incidence study. American Journal of Medicine, 60, 910.
Merikangas, K., Angst, J., Eaton, W., Canino, G., Rubio-Stipec, M., Wacker, H. Wittchen, H.-U., Andrade, L., Essau, C.A., Kraemer, H., Robins, L. & Kupfer, D. (in press) Comorbidity and boundaries of affective disorders with anxiety disorders and substance abuse: results of an international task force. British Journal of Psychiatry.
Merikangas, K.R. & Angst, J. (1990). Depression and migraine. In M. Sandler & G. Collins (Eds.), Migraine: a spectrum of ideas (pp. 248–258). New York: Oxford University Press.
Murphy, J. M., Olivier, D. C. Sobol, A. M. Monson, R. R. & Leighton, A.H. (1986). Diagnosis and outcome: depression and anxiety in a general population. Psychological Medicine, 16, 117–126.
Noyes, R. (1990). The comorbidity and mortality of panic disorder. Psychiatric Medicine, 8, 41–66.
Noyes, R., Clancy, J., Crowe, R. R. & Slyman, D. (1978). The familial prevalence of anxiety neurosis. Archives of General Psychiatry, 135, 555–560.
Noyes, R., Reich, J., Christiansen, J, Suelzer, M., Pfohl, B. & Coryell, W.A. (1990). Outcome of panic disorder: Relationship to diagnostic subtypes and comorbidity. Archives of General Psychiatry, 47, 809–818.
Nutzinger, D. O. & Zapototczy, H.G. (1985). The influence of depression on the outcome of cardiac phobia (panic disorder). Psychopathology, 18, 155–162.
Renneberg, B. (1991). Personality disorders and interactional behaviour of agoraphobic outpatients. Dissertation, Philipps-Universität, Marburg.
Robins, L.N. & Regier, D.A. (Eds.) (1991). Psychiatric disorders in America. The epidemiologic catchment area study. New York: Maxwell Macmillan International
Rouillon, F. & Chignon, J.M. (1992). Psychiatric comorbidity of anxiety disorders. In J. A.E. Costa & L.A. Silva (Eds.), Anxiety disorders in the year 2000. Controversies and perspectives (pp. 26–33). Proceedings of the meeting held in Paris, 9 June 1992. Chester: Adis International.
Shear, M.K., Kligfield, P., Harshfield, G. Devereux, R.B., Polan, J. J. Mann, J. J., Pickering, T. & Frances, A. J. (1987). Cardiac rate and rhythm in panic patients. American Journal of Psychiatry144:633–637.
Stewart, W. F., Schechter, A. & Liberman, J. (1992). Physician consultation for headache pain and history of panic: results from a population based study. American Journal of Medicine, 92 (1A), 1A-355.
Tyrer, P., Casey, P. & Gall, J. (1983). Relationship between neurosis and personality disorder. British Journal of Psychiatry, 142, 404–408.
Üstün, T.B. & Sartorius, N. (1995). An international study of psychosocial disorders in 14 countries: standardized assessment of ill-defined problems in primary care: the background and rationale of the WHO collaborative project on »Psychological Problems in General Health Care«. In J. Miranda, A. Hohmann, C. Atkinson & D. Larson (Eds.) Mental disorders in primary health care. San Francisco: Jossey-Bass.
Valkenburg, C. van, Akiskal, H. S., Puzantian, V. & Rosenthal, T. (1984). Anxious depressions: Clinical, family history, and naturalistic outcome — comparisons with panic and major depressive disorders. Journal of Affective Disorders, 6, 67–82.
Vollrath, M., Koch, R., Angst, J. (1990). The Zurich study. IX. Panic disorder and sporadic panic: symptoms, diagnosis, prevalence, and overlap with depression. European Archives of Psychiatry and Neurological Sciences, 239 (4), 221–230.
Korff, M. von, Eaton, W. & Keyl, P. (1983). The epidemiology of panic attacks and panic disorder: results of three community surveys. American Journal of Epidemiology, 122, 970–981.
Wacker, H. R. (1991). Angst und Depression: Deskriptoren, Prädiktoren: Eine Querschnitts- und Verlaufsuntersuchung [Schweizer Nationalfonds. Schlußbericht. GesuchNr. 32–9373 (3.995–0.87)].
Walker, R.E., Roy-Byrne, P. P., Katon, W.J., Li, L., Ames, D. & Jiranek, G. (1990). Psychiatric illness and irritable bowel syndrome: a comparison with inflammatory bowel disease. American Journal of Psychiatry, 147, 1656.
Weissman, M.M. (1990). Epidemiology of panic disorder and agoraphobia. Psychiatric Medicine8, 3–13.
Weissman, M.M. (1991). Panic disorder: Impact on quality of life. Journal of Clinical Psychiatry, 52 (2), 6–8.
Weissman, M.M., Bland, R., Canino, G., Faravelli, C., Greenwald, S., Hwu, H.-G., Joyce, P.R., Karam, E.G. , Lee, C.K., Lellouch, J., Lepine, J.-P., Newman, S., Rubio-Stipec, M., Wells, J.E., Wickrammaratne, P., Wittchen, H.-U. & Yeh, E.-K. (in press). Cross national aspects of major depression and bipolar disorder. Depression.
Wittchen, H.-U. (1986). Epidemiology of panic attacks and panic disorders. In I. Hand & H.-U. Wittchen (Eds.), Panic and phobias — Empirical evidence of theoretical models and longterm effects of behavioral treatments (pp. 18–28). Berlin: Springer.
Wittchen, H.-U. (1988). Natural course and spontaneous remissions of untreated anxiety disorders — Results of the Munich follow-up study (MFS). In I. Hand & H.-U. Wittchen (Eds.), Panic and Phobias 2. Treatments and variables affecting course and outcome (pp. 3–17). Berlin: Springer.
Wittchen, H.-U. (1991). Der Langzeitverlauf unbehandelter Angststörungen: Wie häufig sind Spontanremissionen? Verhaltenstherapie, 1 (4), 273–282.
Wittchen, H.-U. (1994). Reliability and validity studies of the WHO-composite international diagnostic interview (CIDI): A critical review. Journal of Psychiatric Research, 28 (1), 57–84.
Wittchen, H.-U. (1995). Implikationen von Komorbidität. Verhaltenstherapie, Praxis, Forschung, Perspektiven, 5 (3), 120–133.
Wittchen, H.-U. & Essau, C.A. (1989). Comorbidity of anxiety disorders and depression: does it affect course and outcome? Journal of Psychiatry and Psychobiology, 4, 315–323.
Wittchen, H.-U. & Essau, C. A. (1993 a). Comorbidity and mixed anxiety-depressive disorders: Is there epidemiological evidence? Journal of Clinical Psychiatry.
Wittchen, H.-U. & Essau, C.A. (1993b). Epidemology of anxiety disorders. In R. Michels. (Ed), Psychiat (pp. 1–25). Philadelphia: J. B. Lippincott.
Wittchen, H.-U. & Essau, C.A. (1993 c). Epidemiology of panic disorder: Progress and unresolved issues. Journal of Psychiatric Research, 27, (Suppl. 1), 47–68.
Wittchen, H.-U., Essau, C.A. & Krieg, J. C. (1991). Anxiety disorders: Similarities and differences of comorbidity in treated and untreated groups. British Journal of Psychiatry, 159 (Suppl. 12), 23–33.
Wittchen, H.-U., Schramm, E., Zaudig, M., Mombour, W. & Unland, H. (1993 a). SKID-II. Strukturiertes Klinisches Interview für- DSM-III-R, Achse-II (Persönlichkeitsstörungen): a) Interviewheft. Weinheim: Beltz Test.
Wittchen, H.-U., Schramm, E., Zaudig, M., Mobour, W. & Unland, H. (1993b). SKID II. Strukturiertes Klinisches Interview für DSM-III-R, Achse II (Persönlichkeitsstörungen): b) Manual. Weinheim: Beltz Test.
Wittchen, H.-U., Schramm, E., Zaudig, M. Mombour, W. & Unland, H. (1993c). SKID IL Strukturiertes Klinisches Interview für DSM-III-R, Achse II (Persönlichkeitsstörungen): c) Persönlichkeitsfragebogen. Weinheim: Beltz Test.
Wittchen, H.-U., Essau, C.A., Rief, W. & Fichter, M.M. (1993d). Assessment of somatoform disorders and comorbidity pattern with the CIDI-findings in psychosomatic inpatients. International Journal of Methods in Psychiatric Research, 3 (2), 87–100.
Wittchen, H.-U., Zhao, S., Kessler, R. & Eaton, W.W. (1994). DSM-III-R generalized anxiety disorder in the National Comorbidity Survey. Archives of General Psychiatry, 51, 355–364.
Wittchen, H.-U. & Zerssen, D. von (Hrsg.). (1987). Verläufe behandelter und unbehandelter Depressionen und Angststörungen. — Eine klinisch-psychiatrische und epidemiologische Verlaufsuntersuchung. Berlin: Springer.
Weiterführende Literatur
Kessler, R.C., McGonagle, K.A., Zaho, S., Nelson, C.B., Hughes, M., Eshleman, S., Wittchen, H.-U. & Kendler, K.S. (1994). Lifetime and 12-month prevalence of DSMIII-R psychiatric disorders in the United States: Results from the National Comorbidity Survey. Archives of General Psychiatry51, 8–19
Maser, J.D. & Cloninger C.R. (Eds.) (1990). Comorbidity of mood and anxiety disorders. Washington/DC. London: American Psychiatric Press.
Wittchen, H.-U. (in press). What is comorbidity. Fact of artefact? (Editorial). British Journal of Psychiatry.
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Wittchen, HU., Vossen, A. (1996). Komorbiditätsstrukturen bei Angststörungen Häufigkeit und mögliche Implikationen. In: Margraf, J. (eds) Lehrbuch der Verhaltenstherapie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-08350-5_14
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