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07-SEPTEMBER-2008 03:17:44 - Comorbidity Redirected from Comorbid Look up Comorbidity in Wiktionary, the free dictionary. In medicine, 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. The term dual diagnosis is often applied to the comorbid existence of both a mental disorder and substance abuse. Contents 1 Comorbidity in medicine 1.1 Charlson index 1.2 Diagnosis-related group 2 Mental health 3 References 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. The Charlson Comorbidity is the most widely accepted, validated method, currently used 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, 405: 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. 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. References ^ 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. Retrieved from http://en..org/wiki/Comorbidity Categories: Mental illness diagnosis by DSM and ICD Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages Deutsch Español Français עברית Italiano Nederlands Suomi Svenska This page was last modified on 18 July 2008, at 19:18
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