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Comorbidity

 

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Comorbidity



 
 
In medicine
Medicine

Medicine is the art and science of healing. It encompasses a range of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
, comorbidity (literally "additional morbidity") is either:

The term dual diagnosis
Dual diagnosis

The term dual diagnosis is used to describe the Comorbidity condition of a person considered to be suffering from a Mental disorder and a substance abuse problem....
 is often applied to the comorbid existence of both a mental disorder and a developmental disability
Developmental disability

Developmental disability is a term used to describe life-long Disability attributable to mental and/or physical or combination of mental and physical List of disabilities, manifested prior to age twenty-two....
.

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.






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Encyclopedia


In medicine
Medicine

Medicine is the art and science of healing. It encompasses a range of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
, 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
Dual diagnosis

The term dual diagnosis is used to describe the Comorbidity condition of a person considered to be suffering from a Mental disorder and a substance abuse problem....
 is often applied to the comorbid existence of both a mental disorder and a developmental disability
Developmental disability

Developmental disability is a term used to describe life-long Disability attributable to mental and/or physical or combination of mental and physical List of disabilities, manifested prior to age twenty-two....
.

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
Heart disease

Heart disease is an umbrella term for a variety for different diseases affecting the heart. As of 2007, it is the leading cause of death in the United States, England, Canada and Wales, killing one person every 34 seconds in the United States alone....
, AIDS
AIDS

Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the HIV ....
, or cancer
Cancer

Cancer is a class of diseases in which a group of cell display uncontrolled growth , invasion , and sometimes metastasis . These three malignant properties of cancers differentiate them from benign tumors, which are self-limited, do not invade or metastasize....
 (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
Diagnosis-related group

Diagnosis-related group is a system to classify hospital cases into one of approximately 500 groups, also referred to as DRGs, expected to have similar hospital resource use, developed for Medicare as part of the prospective payment system....
 (DRG) manual splits certain DRGs based on the presence of secondary diagnoses for specific complications or comorbidities (CC).

Mental health


In psychiatry
Psychiatry

Psychiatry is a Medicine Specialty devoted to the Treatment of mental disorders, Biomedical research and Prevention of mental disorder. The term was first coined by the German physician Johann Christian Reil in 1808....
, 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. On the DSM
Diagnostic and Statistical Manual of Mental Disorders

The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides diagnostic criteria for classification of mental disorders....
 Axis I, Major Depressive Disorder is a very common comorbid disorder. The Axis II personality disorder
Personality disorder

Personality disorders, formerly referred to as character disorders, are a class of Personality psychology styles which deviate from the contemporary expectations of a society....
s 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.