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Accepting multiple conditions in psychiatry: From comorbidity to multimorbidity
Christophe Gauld1, Emmanuel D'Incau2, Pauline Espi3
1Department of Child Psychiatry, CHU de Lyon, 69000 Lyon, France; Institut des sciences cognitives Marc-Jeannerod, UMR 5229 CNRS & Université Claude-Bernard Lyon 1, 69000 Lyon, France.
Abstract:
The concept of multimorbidity in psychiatry refers to the coexistence of multiple health conditions without conceptualizing a central disorder referring to a patient-centered approach that views every diagnosis equally. It emphasizes a shift from focusing on an index disorder to considering interrelated symptoms crucial in psychiatry due to frequent multimorbidity patterns. In clinical practice, multimorbidity guides patient-centered care helping to address the holistic needs of patients and challenging the organization of mental health care. In research, multimorbidity reshapes study outcomes and promotes the development of patient-reported outcome questionnaires, also posing ethical challenges and advocating for the inclusion of multimorbid patients in personalized interventions. Finally, multimorbidity in psychiatry has public health implications aligning with the socioecological systems perspective. This notion aims to improve prognosis, care, and health costs while impacting global mortality and challenging the conceptualization and organization of psychiatric care.
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