Comorbid mental disorders: Implications for treatment and sample selection.

Abstract

Disorders from the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; American Psychiatric Association, 1987) were assessed in a birth cohort of 961 young adults. Comorbid cases exceeded single-disordered cases in chronic history of mental illness, use of treatments, physical health problems, functional interference in daily life, and impaired adaptation across domains such as work, education, health, and social-support networks. Single-disorder cases were also more impaired than nondisordered cases, but comorbid cases were the most severely impaired. Our findings suggest that (a) samples that underrepresent comorbidity (pure single-disorder cases or student samples) will underestimate effect sizes for relations between a disorder and its correlates, whereas samples that overrepresent comorbidity (clinical or adjudicated samples) will overestimate effect sizes, (b) comorbidity is accompanied by complications that challenge treatment planning, compliance, and coordination of service delivery, and (c) comorbidity is associated with physical, educational, and economic problems that make it a broad societal concern.

Cognitive Vulnerability–Stress Model of Depression During Adolescence: Investigating Depressive Symptom Specificity in a Multi-Wave Prospective Study

“…This overlap is observed at the level of mood, symptoms, and disorder for many of the most common psychiatric disorders among youth, including anxiety, conduct/oppositional defiant, and attention deficit/hyperactivity (ADHD) (Costello et al 2003;Lewinsohn et al 1993;Newman et al 1998; see Hankin and Abela 2005;Rudolph et al 2006, for reviews). For example, a meta analysis (Angold et al 1999) of depression comorbidity with these other symptoms and disorders among community samples revealed that depression was associated with anxiety (median odds ratio=8.2), conduct/oppositional problems (median odds ratio=6.6), and ADHD (median odds ratio=5.5).…”

The child is father of the man: Personality continuities from childhood to adulthood.

“…The real importance of epidemiology lies in its ability to yield an unbiased understanding of associations between variables, which is especially important for describing and explaining developmental continuity and change across the life course (Costello & Angold, 1995;Rutter, 1982). The importance of a general populatiorl sample is that it avoids those distortions in associations between variables that are very common in volunteer samples or in selected samples of various kinds (e.g., Newman, Moffitt, Caspi, & Silva, 1998).…”

Group psychoeducation for forensic and dangerous non-forensic long-term patients with schizophrenia: A pilot study

“…Also comorbid problems, such as substance abuse and personality disorders, are common among forensic patients. Research has shown that patients with comorbid mental disorders are more resistant to treatment, and are subject to a more chronic course and a poorer prognosis of their illness 1 . Forensic schizophrenic patients often need long-term hospitalization, and before discharge from the hospital becomes possible, clinical forensic psychiatry needs to ascertain that the patient has sufficient insight into illness, has a developed adherence with medication, and is also capable of, and motivated to maintain, long-term use of community psychiatric services 2 .…”