Clustering of chronic disorders--a community study of coprevalence in Jerusalem

Associations between chronic disorders were appraised in a community survey in western Jerusalem in order to identify clusters of mutually related conditions. Two sets of interrelated diseases were observed. The first comprised coronary heart disease, hypertension, diabetes and their complications. The second included migraine and other chronic disorders whose diagnosis was largely based on subjective symptoms. The presence of these complaint-based disorders was associated with a high prevalence of emotional symptoms, with reported difficulties in the life situation, and with frequent doctor visits. The design of appropriate programs of preventive and therapeutic intervention for this cluster of disorders remains an important challenge.