Comorbidity

Jump to: navigation, search

WikiDoc Resources for Comorbidity

Articles

Most recent articles on Comorbidity

Most cited articles on Comorbidity

Review articles on Comorbidity

Articles on Comorbidity in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Comorbidity

Images of Comorbidity

Photos of Comorbidity

Podcasts & MP3s on Comorbidity

Videos on Comorbidity

Evidence Based Medicine

Cochrane Collaboration on Comorbidity

Bandolier on Comorbidity

TRIP on Comorbidity

Clinical Trials

Ongoing Trials on Comorbidity at Clinical Trials.gov

Trial results on Comorbidity

Clinical Trials on Comorbidity at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Comorbidity

NICE Guidance on Comorbidity

NHS PRODIGY Guidance

FDA on Comorbidity

CDC on Comorbidity

Books

Books on Comorbidity

News

Comorbidity in the news

Be alerted to news on Comorbidity

News trends on Comorbidity

Commentary

Blogs on Comorbidity

Definitions

Definitions of Comorbidity

Patient Resources / Community

Patient resources on Comorbidity

Discussion groups on Comorbidity

Patient Handouts on Comorbidity

Directions to Hospitals Treating Comorbidity

Risk calculators and risk factors for Comorbidity

Healthcare Provider Resources

Symptoms of Comorbidity

Causes & Risk Factors for Comorbidity

Diagnostic studies for Comorbidity

Treatment of Comorbidity

Continuing Medical Education (CME)

CME Programs on Comorbidity

International

Comorbidity en Espanol

Comorbidity en Francais

Business

Comorbidity in the Marketplace

Patents on Comorbidity

Experimental / Informatics

List of terms related to Comorbidity

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Background

In medicine and in psychiatry, comorbidity (literally "additional morbidity") is either

  • The presence of one or more disorders (or diseases) in addition to a primary disease or disorder; or
  • The effect of such additional disorders or diseases.

Comorbidity in medicine

In medicine, comorbidity describes the effect of all other diseases an individual patient might have other than the primary disease of interest. There is currently no accepted way to quantify such comorbidity.

Many tests attempt to standardize the “weight” or value of comorbid conditions, whether they are secondary or tertiary illnesses. Each test attempts to consolidate each individual comorbid condition into a single, predictive variable that measures mortality or other outcomes. Researchers have "validated" such tests because of their predictive value, but no one test is as yet recognized as a standard.

The term "comorbid" currently has two definitions: 1) to indicate a medical condition existing simultaneously but independently with another condition in a patient (this is the older and more "correct" definition) 2) to indicate a medical condition in a patient that causes, is caused by, or is otherwise related to another condition in the same patient (this is a newer, nonstandard definition and less well-accepted).

Charlson index

The Charlson co-morbidity index predicts the 1 year mortality for a patient who may have a range of co-morbid conditions such as heart disease, AIDS, or cancer (a total of 22 conditions). Each condition is assigned with a score of 1,2,3 or 6 depending on the risk of dying associated with this condition. Then the scores are summed up and given a total score which predicts mortality. For a physician, it's helpful in knowing how aggressively to treat a condition. e.g. A patient may have cancer, but also heart disease and diabetes so severe that the costs and risks of the treatment outweigh the short term benefit from treatment of the cancer.

Since patients often don't know how severe their conditions are, originally to calculate the index nurses were supposed to go through the patient's chart and determine whether the patient had a particular condition. Subsequent studies have adapted it to a questionnaire for patients.

The original citation follows: Charlson ME, Pompei P, Ales KL, McKenzie CR (1987). A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chron Dis, 40(5): 373-383.

Diagnosis-related group

Patients who are more seriously ill tend to require more hospital resources than patients who are less seriously ill, even though they are admitted to the hospital for the same reason. Recognizing this, the diagnosis-related group (DRG) manual splits certain DRGs based on the presence of secondary diagnoses for specific complications or comorbidities (CC).

Comorbidity in mental health

In psychiatry, psychology and mental health counseling comorbidity refers to the presence of more than one diagnosis occurring in an individual at the same time. In psychiatry, comorbidity does not necessarily imply the presence of multiple diseases, but instead can reflect our current inability to supply a single diagnosis that accounts for all symptoms.[1] On the DSM Axis I, Major Depressive Disorder is a very common comorbid disorder. The Axis II personality disorders are often criticized because their comorbidity rates are excessively high, approaching 60% in some cases, indicating to critics the possibility that these categories of mental illness are too imprecisely distinguished to be usefully valid for diagnostic purposes and, thus, for deciding how treatment resources should be allocated. Comorbidity is also found to be high in drug addicts, both physiologically and psychologically.

References

  1. First MB (2005). "Mutually exclusive versus co-occurring diagnostic categories: the challenge of diagnostic comorbidity". Psychopathology. 38 (4): 206–10. doi:10.1159/000086093. PMID 16145276.



de:Komorbidität he:תחלואה נלווית nl:Comorbiditeit fi:Komorbiditeetti sv:Komorbiditet


Linked-in.jpg