© 2002 The Royal College of Psychiatrists
Deconstructing current comorbidity: data from the Australian National Survey of Mental Health and Well-Being
World Health Organization Collaborating Centre in Evidence for Mental Health Policy, School of Psychiatry, University of New South Wales at St Vincent's Hospital, Sydney, Australia
Correspondence: Professor Gavin Andrews, Clinical Research Unit for Anxiety and Depression, 299 Forbes Street, Darlinghurst, NSW 2010, Australia. Fax: +61 2 9332 4316; e-mail: gavina{at}crufad.unsw.edu.au
Funding detailed in Acknowledgements.
Background Comorbidity in epidemiological surveys of mental disorders is common and of uncertain importance.
Aims To explore the correlates of current comorbidity.
Method Data from the Australian National Survey of Mental Health and Well-Being were used to evaluate the relationships between comorbidity, disability and service utilisation associated with particular mental disorders.
Results The number of current comorbid disorders predicted disability, distress, neuroticism score and service utilisation. Comorbidity is more frequent than expected, which might be due to the effect of one disorder on the symptom level of another, or to the action of common causes on both. The combination of affective and anxiety disorders was more predictive of disability and service utilisation than any other two or three group combinations. When people nominated their principal disorder as the set of symptoms that troubled them the most, the affective and anxiety disorders together were associated with four-fifths of the disability and service utilisation.
Conclusions To make clinical interventions more practical, current comorbidity is best reduced to a principal disorder and subsidiary disorders.
Related articles in BJP:
- Highlights of this issue
- ELIZABETH WALSH
BJP 2002 181: 0.[Full Text]
This article has been cited by other articles:
 |
|
 |
|
  D. Varghese, J. Scott, J. Welham, W. Bor, J. Najman, M. O'Callaghan, G. Williams, and J. McGrath Psychotic-Like Experiences in Major Depression and Anxiety Disorders: A Population-Based Survey in Young Adults Schizophr Bull, August 17, 2009; (2009) sbp083v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. R. Gale, I. J. Deary, S. H. Boyle, J. Barefoot, L. H. Mortensen, and G. D. Batty Cognitive Ability in Early Adulthood and Risk of 5 Specific Psychiatric Disorders in Middle Age: The Vietnam Experience Study Arch Gen Psychiatry, December 1, 2008; 65(12): 1410 - 1418. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. B. Stein, A. N. Simmons, J. S. Feinstein, and M. P. Paulus Increased Amygdala and Insula Activation During Emotion Processing in Anxiety-Prone Subjects Am J Psychiatry, February 1, 2007; 164(2): 318 - 327. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Mittal, J. C. Fortney, J. M. Pyne, M. J. Edlund, and J. L. Wetherell Impact of Comorbid Anxiety Disorders on Health-Related Quality of Life Among Patients With Major Depressive Disorder Psychiatr Serv, December 1, 2006; 57(12): 1731 - 1737. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. E. Markon and R. F. Krueger Categorical and Continuous Models of Liability to Externalizing Disorders: A Direct Comparison in NESARC Arch Gen Psychiatry, December 1, 2005; 62(12): 1352 - 1359. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Maj 'Psychiatric comorbidity': an artefact of current diagnostic systems? The British Journal of Psychiatry, March 1, 2005; 186(3): 182 - 184. [Full Text] [PDF]
|
|
|
|
|
|
G. Andrews, C. Issakidis, K. Sanderson, J. Corry, and H. Lapsley Utilising survey data to inform public policy: comparison of the cost-effectiveness of treatment of ten mental disorders The British Journal of Psychiatry, June 1, 2004; 184(6): 526 - 533. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. ANDREWS, K. SANDERSON, J. CORRY, C. ISSAKIDIS, and H. LAPSLEY Cost-effectiveness of current and optimal treatment for schizophrenia The British Journal of Psychiatry, November 1, 2003; 183(5): 427 - 435. [Abstract] [Full Text] [PDF]
|
|