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1

Williams, Shehan, and Thilini Rajapakse. "Physical illness and psychiatric comorbidity." Sri Lanka Journal of Psychiatry 4, no. 1 (July 3, 2013): 22. http://dx.doi.org/10.4038/sljpsyc.v4i1.5725.

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Sharma, MahendraP. "Comorbidity of mental and physical disorders." Indian Journal of Medical Research 144, no. 5 (2016): 786. http://dx.doi.org/10.4103/0971-5916.203466.

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Lauber, C. "ECP04-01 - Physical and mental comorbidity." European Psychiatry 27 (January 2012): 1. http://dx.doi.org/10.1016/s0924-9338(12)74092-0.

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Qin, Ping, Keith Hawton, Preben Bo Mortensen, and Roger Webb. "Combined effects of physical illness and comorbid psychiatric disorder on risk of suicide in a national population study." British Journal of Psychiatry 204, no. 6 (June 2014): 430–35. http://dx.doi.org/10.1192/bjp.bp.113.128785.

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BackgroundPeople with physical illness often have psychiatric disorder and this comorbidity may have a specific influence on their risk of suicide.AimsTo examine how physical illness and psychiatric comorbidity interact to influence risk of suicide, with particular focus on relative timing of onset of the two types of illness.MethodBased on the national population of Denmark, individual-level data were retrieved from five national registers on 27 262 suicide cases and 468 007 gender- and birth-date matched living controls. Data were analysed using conditional logistic regression.ResultsBoth suicides and controls with physical illness more often had comorbid psychiatric disorder than their physically healthy counterparts. Although both physical and psychiatric illnesses constituted significant risk factors for suicide, their relative timing of onset in individuals with comorbidity significantly differentiated the associated risk of suicide. While suicide risk was highly elevated when onsets of both physical and psychiatric illness occurred close in time to each other, regardless which came first, psychiatric comorbidity developed some time after onset of physical illness exacerbated the risk of suicide substantially.ConclusionsSuicide risk in physically ill people varies substantially by presence of psychiatric comorbidity, particularly the relative timing of onset of the two types of illness. Closer collaboration between general and mental health services should be an essential component of suicide prevention strategies.
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Joshi, R. G., D. R. Shakya, P. M. Shyangwa, and B. Pradhan. "Co-morbidity in women with alcohol dependence syndrome (ADS) in Eastern Nepal." Journal of Psychiatrists' Association of Nepal 5, no. 1 (September 29, 2017): 18–21. http://dx.doi.org/10.3126/jpan.v5i1.18326.

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Introduction: Women with ADS may have psychiatric comorbidites along with physical comorbidities. Societal attitudes towards women and alcohol are barriers to the detection and treatment of their alcohol related problems.Objective: To explore the magnitude of co-morbidity among women with ADS in Eastern Nepal.Method: This is a hospital based cross-sectional study of women with ADS. Those who scored two or more than two in T-ACE questionnaire were enrolled. The diagnosis was made according to ICD-10 criteria. Consultation with concerned physician was done to assess physical condition.Result: Fifty one patients with ADS were enrolled. Among them, 21.6% had no comorbidity, 52.9% had single co-morbidity (psychiatric or physical) and 25.5% had both psychiatric and physical co-morbidity. In psychiatric comorbidity, mood disorder in 35.29% was the commonest followed by nicotine use in 26.47%. Among mood disorders 83.3% had depression. In physical comorbidity, disease of gastrointestinal tract and hepatobiliary system in 50.9% was the commonest followed by hypertension in 11.5%.Conclusion: : Psychiatric as well as physical co-morbidities are common in women with ADS. The finding points to the importance of exploring comorbidities and their optimal treatment.
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Chadda, RK, KN Nishanth, M. Sood, A. Biswas, and R. Lakshmy. "Physical comorbidity in schizophrenia & its correlates." Indian Journal of Medical Research 146, no. 2 (2017): 281. http://dx.doi.org/10.4103/ijmr.ijmr_1510_15.

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Aragonès, Enric, Josep L. Piñol, and Antonio Labad. "Depression and physical comorbidity in primary care." Journal of Psychosomatic Research 63, no. 2 (August 2007): 107–11. http://dx.doi.org/10.1016/j.jpsychores.2007.05.008.

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Kisely, S. R., and D. P. Goldberg. "Physical and Psychiatric Comorbidity in General Practice." British Journal of Psychiatry 169, no. 2 (August 1996): 236–42. http://dx.doi.org/10.1192/bjp.169.2.236.

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BackgroundThe aim of this study was to determine the association between physical and psychiatric morbidity among general practice patients and to explore the influence of possible intervening variables.MethodPhysical and psychiatric morbidity in 1620 consecutive patients attending their general practitioner (GP) was assessed using a two-stage design. Ninety-four per cent of the patients (n=1523) were successfully screened using the General Health Questionnaire (GHQ–12); 428 of the 602 patients (71%) eligible for the second stage were interviewed using the Composite International Diagnostic Instrument adapted for use in primary health care (CIDI–PHC), the Brief Disability Questionnaire (BDQ) and the Groningen Social Disability Schedule (GSDS) to assess psychiatric, physical and social status. Assessments of physical and psychiatric morbidity were also obtained from the patients' GPs.ResultsThere was a significant association between physical and psychiatric morbidity, although patients with four symptoms or less of physical illness were no more likely to be psychiatric cases than those with none. The association was accounted for by patients at the severe end of the physical continuum with five or more medically explained somatic symptoms: these were twice as likely to be psychiatric cases as those with no such symptoms. Female gender, social disability and physical disability were all significantly more likely to be associated with psychiatric disorder, whether measured by GP or research interview; and these relationships remained after the data were corrected for age differences.ConclusionsPatients in general practice with moderate to severe physical morbidity are at increased risk of developing psychiatric illness, and when medical illness is present, psychiatric symptoms are more severe. As physical and psychiatric comorbidity is relatively common in general practice, the specific needs of these patients should receive greater attention.
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Pestana Santos, A., and J. Amílcar Teixeira. "Medical Comorbidity in Schizophrenia." European Psychiatry 41, S1 (April 2017): S276. http://dx.doi.org/10.1016/j.eurpsy.2017.02.114.

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People with schizophrenia have higher prevalence of physical disease and its lifespan is shortened when compared with general population. On average, they die 10 to 25 years earlier than general population.AimThe authors aim to identify the main comorbidities in people with schizophrenia and define strategies to prevent it.MethodsLiterature review on Medline database.ResultsPeople with schizophrenia have higher risk to have hepatitis, cardiovascular diseases, diabetes, overweight, sexual dysfunction and obstetric complications. This high vulnerability is associated with higher rates of preventable risk factors, such as smoking, alcohol consumption, use of street drugs, poor dietary habits and lack of exercise. Moreover, some antipsychotic medications used to treat schizophrenia have been associated with higher incidence of physical disease. At last, there are risk factors attributable to patients and healthcare services. Psychiatrists are often not trained in detection and treatment of physical disease. Despite this, there are several attitudes that can reduce the associated morbidity and mortality in people with schizophrenia, such as improving access to healthcare services, integrated healthcare interventions to enable early diagnosis and promotion of healthy habits.ConclusionsDiagnosis and management of morbidity in people with schizophrenia are more difficult because obstacles related to the patient, the illness, the medical attitudes and the structure of the healthcare services. Regardless these difficulties, the increased frequency of physical disease in people with schizophrenia must be valued due to improved detection and treatment of medical disease will have significant benefits for their psychosocial function and overall quality of life.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Heun, R., and D. Schoepf. "Physical comorbidity and consequences for mortality and treatment." European Psychiatry 33, S1 (March 2016): S39. http://dx.doi.org/10.1016/j.eurpsy.2016.01.882.

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IntroductionAgeing is related to an increase rate of physical comorbidity. However, the interaction between physical comorbidity and the development of depression in the elderly is not yet clear. Depression may be the cause or consequence of physical morbidity. Both may increase mortality.MethodsA total of 9604 patients with depression and a control sample of 96040 patients who attended a general hospital were followed-up for up to 12 years. Physical comorbidity and mortality was assessed.ResultsTwenty-nine physical disorders were more prevalent in subjects with depression, but the effect of individual disorders on mortality did not differ significantly in the depressed and control sample.ConclusionsPatients with depression suffer more physical health problems than control patients that lead to death. The implications for early treatment will be discussed, a preventative approach may be most relevant.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Scott, Kate, Magnus A. McGee, David Schaaf, and Joanne Baxter. "Mental–physical comorbidity in an ethnically diverse population." Social Science & Medicine 66, no. 5 (March 2008): 1165–73. http://dx.doi.org/10.1016/j.socscimed.2007.11.022.

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Lee, Sing, Adley Tsang, Yue-qin Huang, Ming-yuan Zhang, Zhao-rui Liu, Yan-ling He, Michael Von Korff, and Ronald C. Kessler. "Arthritis and physical–mental comorbidity in metropolitan China." Journal of Psychosomatic Research 63, no. 1 (July 2007): 1–7. http://dx.doi.org/10.1016/j.jpsychores.2007.01.007.

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13

Larco, Jonathan P., and Dilip V. Jeste. "Physical comorbidity and polypharmacy in older psychiatric patients." Biological Psychiatry 36, no. 3 (August 1994): 146–52. http://dx.doi.org/10.1016/0006-3223(94)91220-3.

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14

Armiya’u, A. Y., B. I. Lubuola, and P. F. Tungchama. "Physical Co morbidity and Functional Disability amongst Mentally Ill Inmates in Nigerian Prison." Journal of BioMedical Research and Clinical Practice 1, no. 4 (November 23, 2018): 234–40. http://dx.doi.org/10.46912/jbrcp.65.

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Comorbidity is the presence of more than one disorder/condition at the same time, and it is common among those with mental illness. Prisoners with multiple disorders are more disabled and consume more health resources than those with only one disorder. This study aimed at providing prevalence of physical comorbidity among inmates with mental illness and the relationship between physical comorbidity and functional disability among this group of inmates. The study was part of a comprehensive descriptive cross-sectional study carried out among 608 prisoners awaiting trial and convicted in Jos maximum security prison, Plateau state. Four sets of questionnaires were used namely Sociodemograhic Questionnaire (for demographic variable), General Health Questionnaire (GHQ-28) for screening the prisoners for a mental health problem, Composite International Diagnostic Interview (CIDI) which is a structured clinical interview for diagnosing mental health disorders while Physical and functional disabilities were evaluated using the PULSE profile Questionnaire. Out of 608 participants 347 (57.1%) had mental disorders of which 63 (18.2%) had physical comorbidity, with infectious diseases being the commonest physical challenge. Functional disability (level of functioning) was significantly associated with comorbidity cutting across all physical disorders found in the study. The study found high physical comorbidity among mentally ill inmates in the prison studied.
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Nguyen, Lien T. K., Binh N. Do, Dinh N. Vu, Khue M. Pham, Manh-Tan Vu, Hoang C. Nguyen, Tuan V. Tran, et al. "Physical Activity and Diet Quality Modify the Association between Comorbidity and Disability among Stroke Patients." Nutrients 13, no. 5 (May 13, 2021): 1641. http://dx.doi.org/10.3390/nu13051641.

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Background: Comorbidity is common and causes poor stroke outcomes. We aimed to examine the modifying impacts of physical activity (PA) and diet quality on the association between comorbidity and disability in stroke patients. Methods: A cross-sectional study was conducted on 951 stable stroke patients in Vietnam from December 2019 to December 2020. The survey questionnaires were administered to assess patients’ characteristics, clinical parameters (e.g., Charlson Comorbidity Index items), health-related behaviors (e.g., PA using the International Physical Activity Questionnaire- short version), health literacy, diet quality (using the Dietary Approaches to Stop Hypertension Quality (DASH-Q) questionnaire), and disability (using the World Health Organization Disability Assessment Schedule II (WHODAS II)). Linear regression models were used to analyze the associations and interactions. Results: The proportion of comorbidity was 49.9% (475/951). The scores of DASH-Q and WHODAS II were 29.2 ± 11.8, 32.3 ± 13.5, respectively. Patients with comorbidity had a higher score of disability (regression coefficient, B, 8.24; 95% confidence interval, 95%CI, 6.66, 9.83; p < 0.001) as compared with those without comorbidity. Patients with comorbidity and higher tertiles of PA (B, −4.65 to −5.48; p < 0.05), and a higher DASH-Q score (B, −0.32; p < 0.001) had a lower disability score, as compared with those without comorbidity and the lowest tertile of PA, and the lowest score of DASH-Q, respectively. Conclusions: Physical activity and diet quality significantly modified the negative impact of comorbidity on disability in stroke patients. Strategic approaches are required to promote physical activity and healthy diet which further improve stroke rehabilitation outcomes.
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Nowels, Molly A., and Lynn M. VanderWielen. "Comorbidity indices: a call for the integration of physical and mental health." Primary Health Care Research & Development 19, no. 01 (July 20, 2017): 96–98. http://dx.doi.org/10.1017/s146342361700041x.

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Comorbidity indices are commonly used in health services research as a measure of, or as a control for, the severity of a person’s medical state. Currently, there is not a comorbidity index for mental health diagnoses, despite the fact that almost half of Americans have a diagnosable mental health condition at least once in their lifetime. This commentary calls for the integration of mental and behavioral health in comorbidity indices to appropriately account for the role of mental health in overall morbidity and mortality.
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Sartorius, N. "The Complexity of Comorbidity in Patients with Severe Mental Disorders." European Psychiatry 65, S1 (June 2022): S16. http://dx.doi.org/10.1192/j.eurpsy.2022.66.

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Comorbidity of severe mental disorders and physical illness: issues arising Comorbidity of mental and physical illness is a major, perhaps main problem facing medicine in the years before us. In addition to shortening the life expectancy of people with mental illness comorbidity with physical illness comorbidity significantly and negatively affects the quality of life of the people who experience the mental and physical illnesses and their carers and increases the cost of health care. What makes the problem even more and challenging is that medicine is currently in the process of fragmentation into ever more narrow specialties which adds difficulty in the provision of care, Most of the solutions which have been proposed – collaborative care, in-service education of general practitioners and others did not turn out to be effective solutions in dealing with the problems of comorbidity. A significant revision of undergraduate and postgraduate training in medicine is most probably an essential component of the answer to the challenge of this type of comorbidity which will also require a reorganization of health services and their financing. Disclosure No significant relationships.
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Park, Eunyoung, Hyung-Ran Park, and Eui-Sung Choi. "Barriers to and Facilitators of Physical Activity among Korean Female Adults with Knee Osteoarthritis and Comorbidity: A Qualitative Study." Healthcare 8, no. 3 (July 23, 2020): 226. http://dx.doi.org/10.3390/healthcare8030226.

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When knee osteoarthritis is combined with comorbidity, it is associated with limited physical activity. This study aimed to identify barriers to and facilitators of physical activity among Korean female adults with knee osteoarthritis and comorbidity, such as hypertension, diabetes, and dyslipidemia. A qualitative content analysis study was conducted. Ten female knee osteoarthritis participants with comorbidity were recruited at an orthopedic outpatient center in South Korea. Data were collected using in-depth interviews and were analyzed using a conventional content analysis method. Ten participants with a mean age of 70.7 years participated in this study. Four categories of barriers and three of facilitators were identified. Barriers to physical activity were physical hardships, lack of motivation, environmental restrictions, and lack of knowledge. Categories of facilitators were pain management, self-control in physical activity, and understanding the importance of physical activity. Participants did not express any social or environmental facilitators of physical exercise. Healthcare professionals should include social support and environmental facilities to achieve medical and institutional compliance. Understanding female adults with knee osteoarthritis and comorbidity would support provision of appropriately tailored interventions that account for the characteristics of the comorbidity.
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Gauba, Deepak, Pramod Thomas, Yatan P. S. Balhara, and Smita N. Deshpande. "Psychiatric Comorbidity and Physical Correlates in Alcohol-dependent Patients." Indian Journal of Psychological Medicine 38, no. 5 (September 2016): 414–18. http://dx.doi.org/10.4103/0253-7176.191397.

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Andersen, Lars L., Karl B. Christensen, Andreas Holtermann, Otto M. Poulsen, Gisela Sjøgaard, Mogens T. Pedersen, and Ernst A. Hansen. "Effect Of Physical Exercise On Musculoskeletal Pain And Comorbidity." Medicine & Science in Sports & Exercise 41 (May 2009): 20. http://dx.doi.org/10.1249/01.mss.0000353320.61140.b0.

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Sacker, Amanda, Jenny Head, David Gimeno, and Mel Bartley. "Social Inequality in Physical and Mental Health Comorbidity Dynamics." Psychosomatic Medicine 71, no. 7 (September 2009): 763–70. http://dx.doi.org/10.1097/psy.0b013e3181b1e45e.

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Penedo, Frank J., Neil Schneiderman, Jason R. Dahn, and Jeffrey S. Gonzalez. "Physical Activity Interventions in the Elderly: Cancer and Comorbidity." Cancer Investigation 22, no. 1 (January 2004): 51–67. http://dx.doi.org/10.1081/cnv-120027580.

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Basso, Laura, Benjamin Boecking, Patrick Neff, Petra Brueggemann, Christopher R. Cederroth, Matthias Rose, and Birgit Mazurek. "Sex Differences in Comorbidity Combinations in the Swedish Population." Biomolecules 12, no. 7 (July 6, 2022): 949. http://dx.doi.org/10.3390/biom12070949.

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High comorbidity rates, especially mental–physical comorbidity, constitute an increasing health care burden, with women and men being differentially affected. To gain an overview of comorbidity rates stratified by sex across a range of different conditions, this study examines comorbidity patterns within and between cardiovascular, pulmonary, skin, endocrine, digestive, urogenital, musculoskeletal, neurological diseases, and psychiatric conditions. Self-report data from the LifeGene cohort of 31,825 participants from the general Swedish population (62.5% female, 18–84 years) were analyzed. Pairwise comorbidity rates of 54 self-reported conditions in women and men and adjusted odds ratios (ORs) for their comparison were calculated. Overall, the rate of pairwise disease combinations with significant comorbidity was higher in women than men (14.36% vs. 9.40%). Among psychiatric conditions, this rate was considerably high, with 41.76% in women and 39.01% in men. The highest percentages of elevated mental–physical comorbidity in women were found for musculoskeletal diseases (21.43%), digestive diseases (20.71%), and skin diseases (13.39%); in men, for musculoskeletal diseases (14.29%), neurological diseases (11.22%), and digestive diseases (10%). Implications include the need for integrating mental and physical health care services and a shift from a disease-centered to an individualized, patient-centered focus in clinical care.
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Arts, M. "Somatic comorbidity and physical frailty in elderly with medically unexplained symptoms." European Psychiatry 65, S1 (June 2022): S478. http://dx.doi.org/10.1192/j.eurpsy.2022.1214.

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Introduction Reported prevalence rates of medically unexplained symptoms (MUS) in people aged ≥65 years range between 1.5 and 18%. People with MUS often describe a low quality of life and frequently suffer from co-morbid anxiety and depressive disorders. In our pilot study on older patients with MUS, the level of somatic comorbidity as well as frailty parameters were significantly higher among patients with MUS which was partially explained by a somatic origin compared to patients with MUS for which no explanation at all was found. Objectives The objective of this study was to examine the level of frailty and somatic comorbidity in older patients with medically unexplained symptoms (MUS) and compare this to patients with medically explained symptoms (MES). Methods Frailty was assessed according to Fried’s criteria (gait speed, handgrip strength, unintentional weight loss, exhaustion, and low physical activity), somatic comorbidity according to the self-report Charlson Comorbidity Index and the number of prescribed medications. Results Although MUS-patients had less physical comorbidity compared to MES-patients, they were prescribed the same number of medications. Moreover, MUS-patients were more often frail compared to MES-patients. Among MUS-patients, physical frailty was associated with the severity of unexplained symptoms, the level of hypochondriacal beliefs, and the level of somatisation. Conclusions Despite a lower prevalence of overt somatic diseases, MUS-patients are more frail compared to older MES-patients. These results suggest that at least in some patients age-related phenomena might be erroneously classified as MUS, which may affect treatment strategy. Disclosure No significant relationships.
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Radner, Helga, Josef S. Smolen, and Daniel Aletaha. "Impact of comorbidity on physical function in patients with rheumatoid arthritis." Annals of the Rheumatic Diseases 69, no. 3 (October 12, 2009): 536–41. http://dx.doi.org/10.1136/ard.2009.118430.

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BackgroundPhysical disability is a main outcome in rheumatoid arthritis (RA) which tends to increase with comorbidities. However, the extent to which comorbidities contribute to the multifactorial process of disability has not been investigated.ObjectiveTo quantify the contribution of comorbidity to physical disability in patients with RA.MethodsIn a prospective cohort study, age-adjusted Charlson comorbidity index (CCIA), serial measurements of disease activity and functional disability (evaluated by the Health Assessment Questionnaire Disability Index, HAQ) of 380 patients with established RA seen at an outpatient clinic over 1 year (June 2007 to July 2008) were ascertained. The association between comorbidity and physical disability was assessed using analysis of variance (ANOVA) and adjusted general linear regression models.ResultsFour patient groups with increasing levels of comorbidity (CCIA 0, 1–2, 3–4 and 5–9; potential range 0–38) were defined. Mean HAQ scores were significantly different across these groups (0.67, 0.80, 1.24, 1.40, respectively; p<0.001) and also when adjusted for disease activity, gender and disease duration in the regression model (0.84, 0.88, 1.14, 1.48, respectively; p<0.001). The effects of CCIA on disability were similar within different strata of disease activity: namely, remission (0.26, 0.31, 0.48 and 0.88, p<0.01); low disease activity (0.83, 0.78, 0.98 and 1.36, p<0.01); and moderate to high disease activity (1.22, 1.33, 1.70 and 1.91, p<0.01), and thus were independent of disease activity. Several sensitivity analyses, including the use of the Short Form Health Survey (SF-36), confirmed these observations.ConclusionPhysical disability becomes worse with increasing levels of comorbidity, irrespective of disease activity.
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Scott, K. M., J. Kokaua, and J. Baxter. "Does Having a Chronic Physical Condition Affect the Likelihood of Treatment Seeking for a Mental Health Problem and Does This Vary by Ethnicity?" International Journal of Psychiatry in Medicine 42, no. 4 (November 2011): 421–36. http://dx.doi.org/10.2190/pm.42.4.f.

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Objective: The comorbidity of mental disorders with chronic physical conditions is known to have important clinical consequences, but it is not known whether mental-physical comorbidity influences mental health treatment seeking. This study investigates whether the presence of a chronic physical condition influences the likelihood of seeking treatment for a mental health problem, and whether that varies among ethnic subgroups in New Zealand. Methods: Analyses were based on a subsample ( n = 7,435) of The New Zealand Mental Health Survey, a nationally representative household survey of adults (response rate 73.3%). Ethnic subgroups (Maori and Pacific peoples) were oversampled. DSM-IV mental disorders were measured face-to-face with the Composite International Diagnostic Interview (CIDI 3.0). Ascertainment of chronic physical conditions was via self-report. Results: In the general population, having a chronic medical condition increased the likelihood of seeking mental health treatment from a general practitioner (OR: 1.58), as did having a chronic pain condition (OR: 2.03). Comorbid chronic medical conditions increased the likelihood of seeking mental health treatment most strongly among Pacific peoples (ORs: 2.86–4.23), despite their being less likely (relative to other ethnic groups) to seek mental health treatment in the absence of physical condition comorbidity. Conclusion: In this first investigation of this topic, this study finds that chronic physical condition comorbidity increases the likelihood of seeking treatment for mental health problems. This provides reassurance to clinicians and health service planners that the difficult clinical problem of mental-physical comorbidity is not further compounded by the comorbidity itself constituting a barrier to mental health treatment seeking.
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Court, Helen. "Visual impairment and physical and mental health comorbidities." Optician 2016, no. 7 (July 2016): 143062–1. http://dx.doi.org/10.12968/opti.2016.7.143062.

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Becarevic, N., R. Softic, and M. Becarevic. "Somatic Comorbidity of Anxious and Depressed Miners." European Psychiatry 65, S1 (June 2022): S462—S463. http://dx.doi.org/10.1192/j.eurpsy.2022.1174.

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Introduction Depression is the leading cause of disability worldwide and is a major contributor to the overall global burden of disease. The prevalence of depression is rising and it often co-occurs with other physical diseases. Objectives The research aims to determine the comorbidity of depression and anxiety disorders with chronic physical diseases among employees of the „Brown coal mine Banovici“. Methods We conducted a retrospective study that included 117 employees from the disease registry who are being under the treatment of depression and anxiety disorder. We collected data from medical records of patients about sex, age, marital status, smoking status, physical diseases, types of antidepressants, and the other drugs they use. Results The study showed that there are 117 employees of the „Brown coal mine Banovici“ who are under treatment of depression and anxiety-depressive disorder. 22 (18,8%) of them are females and 95 (81,2%) males in an average life span of 48,3 years. The most commonly used antidepressant is Escitalopram. 62 (53%) out of 117 patients with depression have comorbidity with diseases of the circulatory system, 24 (20,51%) have comorbidity with diseases of the musculoskeletal system and connective tissue, 16 (13,68%) have comorbidity with endocrine, nutritional and metabolic diseases. 25 (21,37%) patients are not suffering from any other chronic physical disease. The most commonly used drugs besides antidepressants are antihypertensives. Conclusions The comorbidity rate of depression and anxiety disorders with cardiovascular diseases among employees of the „Brown coal mine Banovici“ is higher than with all other chronic physical diseases. Disclosure No significant relationships.
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Baldwin, DS. "Depression and panic: Comorbidity." European Psychiatry 13, S2 (1998): 65s—70s. http://dx.doi.org/10.1016/s0924-9338(98)80016-3.

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SummaryPanic disorder is a common condition. Epidemiological studies throughout the world consistently indicate that the lifetime prevalence of panic disorder (with or without agoraphobia) is between 1.5% and 3.5%. Panic disorder shows substantial comorbidity with other forms of mental illness. Major depressive disorder occurs in 50 to 65% of individuals with panic disorder and there is considerable cross-sectional and longitudinal comorbidity with recurrent brief depression and dysthymia. Phobic anxiety disorders, most notably social phobia and generalised anxiety disorder, commonly occur with panic disorder, especially in individuals with more severe agoraphobia. Approximately 35 to 50% of individuals with panic disorder in community settings also have agoraphobia. Panic disorder also shows significant comorbidity with physical illness. Compared with individuals without or with some other psychiatric diagnosis, patients with panic disorder have an increased risk of suffering from multiple medically unexplained symptoms and are associated with high use of medical services and increased mortality from both cardiovascular and cerebrovascular disease.
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Marrie, RA, R. Horwitz, G. Cutter, T. Tyry, D. Campagnolo, and T. Vollmer. "Comorbidity, socioeconomic status and multiple sclerosis." Multiple Sclerosis Journal 14, no. 8 (July 16, 2008): 1091–98. http://dx.doi.org/10.1177/1352458508092263.

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Objective Multiple sclerosis (MS) is associated with substantial morbidity. The impact of comorbidity on MS is unknown, but comorbidity may explain some of the unpredictable progression. Comorbidity is common in the general population, and is associated with adverse health outcomes. To begin understanding the impact of comorbidity on MS, we need to know the breadth, type, and frequencies of comorbidities among MS patients. Using the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry, we aimed to describe comorbidities and their demographic predictors in MS. Methods In October 2006, we queried NARCOMS participants regarding physical comorbidities. Of 16,141 participants meeting the inclusion criteria, 8983 (55.7%) responded. Results Comorbidity was relatively common; if we considered conditions which are very likely to be accurately self-reported, then 3280 (36.7%) reported at least one physical comorbidity. The most frequently reported comorbidities were hypercholesterolemia (37%), hypertension (30%), and arthritis (16%). Associated with the risk of comorbidity were being male [females vs. males, odds ratio (OR) 0.77; 0.69–0.87]; age (age >60 years vs. age ≤44 years, OR 5.91; 4.95–7.06); race (African Americans vs. Whites, OR 1.46; 1.06–2.03); and socioeconomic status (Income <$15,000 vs. Income >$100,000, OR 1.37; 1.10–1.70). Conclusions Comorbidity is common in MS and similarly associated with socioeconomic status.
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Hainsworth, Keri R., Lawrence A. Miller, Stacy C. Stolzman, Brian M. Fidlin, W. Hobart Davies, Steven J. Weisman, and Joseph A. Skelton. "Pain as a Comorbidity of Pediatric Obesity." ICAN: Infant, Child, & Adolescent Nutrition 4, no. 5 (August 22, 2012): 315–20. http://dx.doi.org/10.1177/1941406412458315.

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The purpose of this study was to document the prevalence and characteristics of physical pain in a sample of severely obese children and adolescents. In this retrospective chart review, primary measures included current and past pain, pain intensity, and pain characteristics during a 5-minute walk test. Pain assessments for 74 patients (mean age 11.7 years; 53% female; 41% African American) were conducted by a physical therapist. Past pain was reported by 73% of the sample, with 47% reporting pain on the day of program enrollment. Although average pain intensity was moderate (M = 5.5/10), alarmingly, 42% of those with current pain reported severe pain (6/10 to 10/10). Overall, pain occurred primarily in the lower extremities and with physical activity. Patients reporting current pain had a significantly higher body mass index than those reporting no pain. These findings suggest that pain is common in severely obese youth, and furthermore, that pain should be recognized as a comorbidity of pediatric obesity. Routinely screening severely obese children and adolescents for pain presence and intensity is recommended.
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Gautam, Shiv. "Fourth revolution in psychiatry - Addressing comorbidity with chronic physical disorders." Indian Journal of Psychiatry 52, no. 3 (2010): 213. http://dx.doi.org/10.4103/0019-5545.70973.

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Jürisson, Mikk, Heti Pisarev, Anneli Uusküla, Katrin Lang, Marje Oona, Lisanna Elm, and Ruth Kalda. "Physical-mental health comorbidity: A population-based cross-sectional study." PLOS ONE 16, no. 12 (December 2, 2021): e0260464. http://dx.doi.org/10.1371/journal.pone.0260464.

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Background Multimorbidity is associated with physical-mental health comorbidity (PMHC). However, the scope of overlap between physical and mental conditions, associated factors, as well as types of mental illness involved are not well described in Eastern Europe. This study aims to assess the PMHC burden in the Estonian population. Methods In this population-based cross-sectional study we obtained health claims data for 55 chronic conditions from the Estonian Health Insurance Fund (EHIF) database, which captures data for all publicly insured individuals (n = 1 240 927 or 94.1% of the total population as of 31 December 2017). We assessed the period-prevalence (3 years) of chronic physical and mental health disorders, as well as associations between them, by age and sex. Results Half of the individuals (49.1% (95% CI 49.0–49.3)) had one or more chronic conditions. Mental health disorders (MHD) were present in 8.1% (8.1–8.2) of individuals, being higher among older age groups, women, and individuals with a higher number of physical conditions. PMHC was present in 6.2% (6.1–6.2) of the study population, and 13.1% (13.0–13.2) of the subjects with any chronic physical disorder also presented with at least one MHD. Dominating MHDs among PMHC patients were anxiety and depression. The prevalence of MHD was positively correlated with the number of physical disorders. We observed variation in the type of MHD as the number of physical comorbidities increased. The prevalence of anxiety, depression, and mental and behavioral disorders due to the misuse of alcohol and other psychoactive substances increased as physical comorbidities increased, but the prevalence of schizophrenia and dementia decreased with each additional physical disease. After adjusting for age and sex, this negative association changed the sign to a positive association in the case of dementia and mental and behavioral disorders due to psychoactive substance misuse. Conclusions The burden of physical-mental comorbidity in the Estonian population is relatively high. Further research is required to identify clusters of overlapping physical and mental disorders as well as the interactions between these conditions. Public health interventions may include structural changes to health care delivery, such as an increased emphasis on integrated care models that reduce barriers to mental health care.
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Kang, Hee-Ju, Seon-Young Kim, Kyung-Yeol Bae, Sung-Wan Kim, Il-Seon Shin, Jin-Sang Yoon, and Jae-Min Kim. "Comorbidity of Depression with Physical Disorders: Research and Clinical Implications." Chonnam Medical Journal 51, no. 1 (2015): 8. http://dx.doi.org/10.4068/cmj.2015.51.1.8.

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Mancuso, Carol A., Marina Stal, Roland Duculan, and Federico P. Girardi. "Physical and Psychological Comorbidity Independently Associated With Spine-Related Disability." Spine 39, no. 23 (November 2014): 1969–74. http://dx.doi.org/10.1097/brs.0000000000000569.

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36

Lateef, Tarannum M., Lihong Cui, Karin B. Nelson, Erin F. Nakamura, and Kathleen R. Merikangas. "Physical Comorbidity of Migraine and Other Headaches in US Adolescents." Journal of Pediatrics 161, no. 2 (August 2012): 308–13. http://dx.doi.org/10.1016/j.jpeds.2012.01.040.

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37

Matson, Michael L., Johnny L. Matson, and Jennifer S. Beighley. "Comorbidity of physical and motor problems in children with autism." Research in Developmental Disabilities 32, no. 6 (November 2011): 2304–8. http://dx.doi.org/10.1016/j.ridd.2011.07.036.

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Kriegsman, Didi M. W., Dorly J. H. Deeg, and Wim A. B. Stalman. "Comorbidity of somatic chronic diseases and decline in physical functioning:." Journal of Clinical Epidemiology 57, no. 1 (January 2004): 55–65. http://dx.doi.org/10.1016/s0895-4356(03)00258-0.

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39

Erving, Christy L. "Physical-psychiatric comorbidity: patterns and explanations for ethnic group differences." Ethnicity & Health 23, no. 6 (February 7, 2017): 583–610. http://dx.doi.org/10.1080/13557858.2017.1290216.

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40

Arroita, A., A. Barreiro, K. Ugarte, N. Losada, P. Rico, R. Touzon, and M. D. M. Lopez. "Psychiatric Comorbidity in Fibromyalgia." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)70842-9.

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Introduction:Fibromyalgia is an entity that affects approximately 2% of the population, mainly women.According to many studies, approximately half of women with fibromyalgia have a history of traumatic events during childhood or adulthood.Affective disorders before and after fibromyalgia diagnosis are particularly frequent.Materials and methods:Comprehensive review of the scientific literature (Medline, Psychoinfo, Medex) on psychiatric comorbidity in women diagnosed with fibromyalgia published over the last three years.Results:40-60% of women diagnosed with fibromyalgia report sexual abuse during childhood or adulthood; A higher percentage of women (over 70%) report other kinds of physical or emotional trauma.Fibromyalgia has been linked to mood disorders in 50-70% of patients. More precisely, it appears in combination with major depression in 20% of cases. To a lesser but still noteworthy extent, women with fibromyalgia are also diagnosed with dysthymia, anxiety disorders, phobias or panic disorders.Conclusion:Despite the common characteristics of these patients there is no such thing as a “fibromyalgic personality”.As for comorbidity, mood disorders are highly prevalent, more specifically depression, even though no direct relationship has been established between them. Fibromyalgia symptoms are more acute in patients with comorbid psychiatric disorders.
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41

Kharitonova, L. A., K. I. Grigoriev, I. M. Osmanov, S. N. Borzakova, E. V. Skorobogatova, V. A. Shashel, S. Yu Matalaeva, and D. A. Shurygina. "Digestive comorbidity in pediatrics." Experimental and Clinical Gastroenterology 1, no. 1 (March 17, 2021): 166–75. http://dx.doi.org/10.31146/1682-8658-ecg-185-1-166-175.

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Rationale. In recent decades, the number of children has increased with chronic diseases characterized by systemic lesions and frequent involvement of the digestive tract, complicating the diagnosis and choice of therapeutic strategy. As the number of diseases in a child increases, the cost of diagnosis and treatment grows exponentially. Given the comorbidity, physicians prescribe multiple medications (polypragmasy), which can lead to adverse effects.First-line physicians often lack the knowledge about the clinical and therapeutic features of managing comorbid patients. Practical healthcare lacks a “team strategy” for these patients’ treatment, leading to ineffective management of patients by subspecialist physicians significantly affecting the prognosis of the disease and even the life of the patient. The “narrowly specialized” model of medicine is inadequate. An integrative model of healthcare should replace it. Meanwhile, there are currently no international and national recommendations for this problem focused on the needs of “first line” physicians, including pediatric specialists. All the above urged us to provide an in-depth study of this problem in the current literature.The aim of this literature review was to study the frequency and structure of comorbid conditions in pediatric practice to optimize their diagnostics, therapeutic tactics, and the development of preventive measures.Results and discussion. The structure of comorbidity differs in different age categories. The comorbidity in children depends mainly on the genetically programmed disorders of metabolism and functioning of cells and tissues, disorders of nutritional status, infectious factors, and interference (pathogenetic relationship of diseases). Understanding the etiology and pathogenesis of comorbid conditions in children, one should identify the Chronic Noncommunicable Diseases formation risk groups and develop a plan for their prevention. Prevention of comorbid chronic noncommunicable diseases should be carried out as part of the “full life cycle”, from the antenatal period (the health of the future mother) to adolescence, using an integrative approach (impact on the child’s physical and mental condition) with teaching patients and their parents the basics of proper diet, healthy lifestyle, sufficient physical activity, and positive attitude.Knowledge of causal and complicated comorbidity will contribute to the development of optimal diagnostic tactics for the search of the root cause and the selection of efficient therapy for trigger disease, which will avoid polypragmasy. The pediatric physician should play the primary role in the follow-up of comorbid patients. It is necessary to expand the competencies of the pediatric physician with the revision of approaches to his professional training.The development of clinical guidelines and algorithms for the management of comorbid patients and the collaboration of physicians of various specialties (formation of multidisciplinary teams), while observing the principle of “one doctor”, will significantly improve the quality of medical care for comorbid patients, which will improve their quality of life and significantly decrease the cost of rehabilitation measures.
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Von Korff, Michael, Paul Crane, Michael Lane, Diana L. Miglioretti, Greg Simon, Kathleen Saunders, Paul Stang, Nancy Brandenburg, and Ronald Kessler. "Chronic spinal pain and physical–mental comorbidity in the United States: results from the national comorbidity survey replication." Pain 113, no. 3 (February 2005): 331–39. http://dx.doi.org/10.1016/j.pain.2004.11.010.

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43

Chen, Ronald C., Bryce B. Reeve, Allison Mary Deal, Dominic T. Moore, and James Austin Talcott. "Association between baseline physical function and comorbidity status with patient-reported quality of life after prostate cancer treatments: Combined analysis of two prospective cohort studies." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): 6107. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.6107.

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6107 Background: Treatment-related bowel, urinary, and sexual dysfunction in prostate cancer patients varies by treatment type, baseline function and other patient factors. To better predict patient outcomes after treatment, we examined the impact of comorbidity on these quality of life (QOL) outcomes in a secondary data analysis of two pooled, prospective cohort studies. Methods: A total of 697 patients from 3 academic hospitals who received radical prostatectomy, external beam radiation, or brachytherapy were included. Using a validated instrument, patients reported bowel, urinary, and sexual symptoms pretreatment, and at 3, 12, 24, and 36 months after treatment. Baseline physical function was measured by the physical component summary score (PCS) of the SF-12 using patient report. Comorbidity as measured by the Index of Co-Existent Disease (ICED) was obtained from medical record review. Repeated QOL measurements were analyzed using a mixed modeling method, by random coefficient modeling. Separate models were built for each outcome using bowel, urinary, and sexual scale scores at each time point.Covariates in all models included baseline age, education, ICED, and PCS. Results: Approximately 70% of patients had one or more comorbid conditions at baseline. After adjusting for age and education in mixed-models, we found baseline comorbidity was independently associated with more sexual dysfunction (p<.001) and urinary incontinence (p=.03). Worse baseline physical functioning was independently associated with more bowel problems (p<.001) and sexual dysfunction (p<.001). There were no treatment by comorbidity or physical functioning interactions. Conclusions: Comorbidity and worse physical functioning at baseline are significantly associated with poorer bowel, urinary, and sexual function after treatment for prostate cancer, but the associations do not appear to differ by treatment. Patients with comorbidity recovered more slowly. This information may help patients and their physicians anticipate outcomes after surgical and radiation treatments.
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Daniele, Thiago Medeiros da Costa, Veralice Meireles Sales de Bruin, Débora Siqueira Nobre de Oliveira, Clara Mota Randal Pompeu, and Adriana Costa e. Forti. "Associations among physical activity, comorbidities, depressive symptoms and health-related quality of life in type 2 diabetes." Arquivos Brasileiros de Endocrinologia & Metabologia 57, no. 1 (February 2013): 44–50. http://dx.doi.org/10.1590/s0004-27302013000100006.

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OBJECTIVE: To investigate associations between physical activity, comorbidity severity, depressive symptoms, and health-related quality of life in type 2 diabetes mellitus. SUBJECTS AND METHODS: All individuals, 200 patients and 50 controls, aged from 40 to 60 years, were investigated by interview, and all variables were measured concurrently. Physical activity was evaluated by the International Physical Activity Questionnaire (IPAQ), Health-Related Quality of Life (HRQL) by the Short-Form Health Survey (SF-36), comorbidity severity by the Charlson Comorbidity Index (CCI), and depressive symptoms by the Beck Depression Inventory (BDI-II > 16). Single and multiple regression analysis evaluated the effects of independent variables on physical activity. RESULTS: The patients had more depressive symptoms and greater comorbidity severity (p < 0.005). Diabetic patients showed better activity levels (IPAQ) (p < 0.005). Functional Capacity, General State of Health, and Physical Limitation were the most affected subscales in the SF-36 evaluation of the HRQL. Sedentary diabetic patients had higher waist circumference, waist-to-hip ratios, more depressive symptoms, and worse HRQL. Functional capacity (p = 0.000), followed by General State of Health (p = 0.02), were the health status measure subscales independently associated with physical activity. Conclusions: The findings suggest that increasing patient independence and treating depressive symptoms can promote physical activity for type 2 diabetes mellitus patients. It is suggested that group activities and caregivers/family support might compensate for the patient dependence, and increase adherence to exercise programs in those that are less active.
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Seifert, Olga, and Christoph Baerwald. "Mental Comorbidity in Rheumatic Diseases." Aktuelle Rheumatologie 46, no. 03 (April 13, 2021): 249–57. http://dx.doi.org/10.1055/a-1404-3089.

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AbstractIn this review, we summarise the most relevant studies in a PubMed Search term “mental disorders and rheumatic disease” in the last 15 years. Mental disorders such as depression and anxiety are common in people with rheumatic diseases. Treating these comorbidities can improve the patientʼs quality of life. The high prevalence of symptoms of psychiatric disorders is a challenge for rheumatologists, especially with regard to the differentiation of possible psychiatric components in rheumatological diseases. Screening for psychiatric problems in patients with rheumatic diseases should be evaluated as soon as possible, as these can have a major influence on the perception of pain and physical functioning status from the outset. Mental health disorders are seen as a risk factor for poor patient outcomes, as patients may not adhere to medical treatments. The potential side effects of biological agents can increase patient anxiety and affect adherence to therapy. Therefore, interdisciplinary care would be of great advantage in the treatment of rheumatic patients with psychological comorbidities.
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Zhang, Tingting, Helen Tremlett, Feng Zhu, Elaine Kingwell, John D. Fisk, Virender Bhan, Trudy Campbell, et al. "Effects of physical comorbidities on disability progression in multiple sclerosis." Neurology 90, no. 5 (January 3, 2018): e419-e427. http://dx.doi.org/10.1212/wnl.0000000000004885.

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ObjectiveTo examine the association between physical comorbidities and disability progression in multiple sclerosis (MS).MethodsWe conducted a retrospective cohort study using linked health administrative and clinical databases in 2 Canadian provinces. Participants included adults with incident MS between 1990 and 2010 who entered the cohort at their MS symptom onset date. Comorbidity status was identified with validated algorithms for health administrative data and was measured during the 1 year before study entry and throughout the study period. The outcome was the Expanded Disability Status Scale (EDSS) score as recorded at each clinic visit. We used generalized estimating equations to examine the association between physical comorbidities and EDSS scores over time, adjusting for sex, age, cohort entry year, use of disease-modifying drugs, disease course, and socioeconomic status. Meta-analyses were used to estimate overall effects across the 2 provinces.ResultsWe identified 3,166 individuals with incident MS. Physical comorbidity was associated with disability; with each additional comorbidity, there was a mean increase in the EDSS score of 0.18 (95% confidence interval [CI] 0.09–0.28). Among specific comorbidities, the presence of ischemic heart disease (IHD) or epilepsy was associated with higher EDSS scores (IHD 0.31, 95% CI 0.01–0.61; epilepsy 0.68, 95% CI 0.11–1.26).ConclusionsPhysical comorbidities are associated with an apparent increase in MS disability progression. Appropriate management of comorbidities needs to be determined to optimize outcomes.
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Anderson, Melissa L., Douglas M. Ziedonis, and Lisa M. Najavits. "Posttraumatic Stress Disorder and Substance Use Disorder Comorbidity Among Individuals With Physical Disabilities:Findings From the National Comorbidity Survey Replication." Journal of Traumatic Stress 27, no. 2 (March 21, 2014): 182–91. http://dx.doi.org/10.1002/jts.21894.

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48

Bjerke, T., and R. Wynn. "Physical training for inpatients." European Psychiatry 64, S1 (April 2021): S791. http://dx.doi.org/10.1192/j.eurpsy.2021.2091.

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IntroductionThere is a high degree of comorbidity between serious mental illness (SMI) and substance use disorders (SUD) and cardiovascular disorders. Other life-style related disorders are also common in patients with SMI and SUD. Consequently, comorbidity with somatic diseases contributes to a dramatic reduction in life-expectancy for these patient groups. Physical training has been shown to have positive effects also for mental health, but there has been little systematic use of physical training as part of the treatment for patients suffering from SMI and SUD in Norwegian health care.ObjectivesTo present a new project on physical training for patients suffering from SMI and SUD.MethodsWe briefly describe a project in a major Norwegian hospital, where physical exercise will be offered as part of the treatment for patients suffering from SMI and SUD.ResultsThe Division for Substance Use and Mental Health now offers an exercise room for inpatients at the main clinic in Tromsø, Norway. The exercise room contains various equipment including treadmills and equipment for strength training. This facility has recently been made available and is currently being used by a selection of patients. A study of user experiences is forthcoming and a systematic study of effects of physical exercise for patients suffering from SMI and SUD is being planned.ConclusionsPhysical exercise has been shown to have positive effects also on mental health. In one major Norwegian hospital, facilities are now offered for inpatients suffering from SMI or SUD. The effects of physical exercise on patients with SMI and SUD will be examined.DisclosureNo significant relationships.
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Welsh, Emily R., and Geoffry Phillips McEnany. "Approaches to Reduce Physical Comorbidity in Individuals Diagnosed With Mental Illness." Journal of Psychosocial Nursing and Mental Health Services 53, no. 2 (February 1, 2015): 32–37. http://dx.doi.org/10.3928/02793695-20150120-01.

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50

Gierz, Monika, and Dilip V. Jeste. "Physical Comorbidity in Elderly Veterans Affairs Patients With Schizophrenia and Depression." American Journal of Geriatric Psychiatry 1, no. 2 (March 1993): 165–70. http://dx.doi.org/10.1097/00019442-199300120-00010.

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