Comorbidities in Mental Health

Different minds.
Comorbidity means having more than one diagnosis. Getty / DrAfter123
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Comorbidities are more than one disorder in the same person. For example, if a person is diagnosed with both social anxiety disorder (SAD) and major depressive disorder (MDD), they are said to have comorbid (meaning co-existing) anxiety and depressive disorders.

Other comorbid conditions include physical ailments such as diabetes, cardiovascular disease, cancer, infectious diseases, and dementia. Mental health conditions that tend to show comorbidity include eating disorders, anxiety disorders, and substance abuse.

The term comorbidity was coined in the 1970s by A.R. Feinstein, a renowned American doctor and epidemiologist. Feinstein demonstrated comorbidity through the example of how people with rheumatic fever also usually suffered from multiple other diseases. Since that time, comorbidity has come to be associated with the presence of multiple mental or physical health conditions in the same person.

Prevalence of Comorbidities

It's not uncommon for people to be diagnosed with two disorders or conditions at once. Comorbidity in mental illness can include a situation where a person receives a medical diagnosis that is followed by the diagnosis of a mental disorder (or vice versa), or it can involve the diagnosis of a mental disorder that is followed by the diagnosis of another mental disorder.

A large, cross-sectional, national epidemiological study of comorbid conditions in mental health in Spain showed that among a sample of 7936 adult patients, about half had more than one psychiatric disorder. Furthermore, in the U.S. National Comorbidity Survey, 51% of patients with a diagnosis of major depression also had at least one anxiety disorder. Only 26% of them had no other mental health condition.

In the Early Developmental Stages of Psychopathology Study, 48.6% of patients with a diagnosis of major depression also had at least one anxiety disorder. Just over one-third (34.8%) had no other mental disorder.

Treatment Challenges in Comorbidities

Overlap of medical conditions with psychiatric conditions is a significant challenge for healthcare professionals. For example, a person diagnosed with both diabetes and depression would be treated for both conditions, but consideration for overlap between medications and symptoms would need to be coordinated by the various health care professionals offering treatment.

If you live with multiple conditions or disorders, it is important that your doctor is aware of all medications and over-the-counter drugs you are taking, to ensure the risk of medication interactions is reduced.

Can Comorbidities Be Prevented?

Healthcare professionals can play a role in preventing comorbidity. For example, if a social anxiety disorder is left untreated for a long period of time, a person may also develop depression and/or substance abuse in response to the anxiety symptoms. So prompt diagnosis and treatment of one condition may prevent the development of comorbidities.

At a broader level, coordination between primary doctors and mental health professionals is key to preventing comorbid conditions. If you've been diagnosed with a physical and/or mental health condition, keep good records of the care that you receive from various professionals, so that each can be aware of the various treatments you are receiving.

A Word From Verywell

If you feel that you have symptoms of more than one mental disorder or those of a physical health condition in addition to a mental disorder, it is important to consult with your primary care physician or mental health professional to determine the best course of action. The unique combination of symptoms that you experience will determine whether medication and/or therapy is best for your situation.

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