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Comorbid mental disorders: implications for treatment and sample selection

D L Newman1, T E Moffitt, A Caspi

  • 1Department of Psychology, University of Wisconsin-Madison, USA.

Journal of Abnormal Psychology
|May 30, 1998
PubMed
Summary
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Mental health comorbidity, the presence of multiple disorders, leads to more severe illness, treatment challenges, and broader societal issues. Understanding comorbidity is crucial for accurate research and effective care.

Area of Science:

  • Psychiatry
  • Epidemiology
  • Public Health

Background:

  • Mental health disorders are prevalent in young adults.
  • The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a key diagnostic tool.
  • Understanding the impact of comorbidity is essential for mental health research and practice.

Purpose of the Study:

  • To assess mental disorders in a birth cohort of young adults.
  • To compare the impairment levels between individuals with single disorders, comorbid disorders, and no disorders.
  • To investigate the implications of comorbidity for research, treatment, and societal impact.

Main Methods:

  • A birth cohort of 961 young adults was assessed for disorders using the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.).

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  • Data collected included history of mental illness, treatment use, physical health, functional interference, and adaptation across life domains.
  • Statistical comparisons were made between single-disorder, comorbid-disorder, and non-disordered groups.

    • Main Results:

    • Comorbid cases exhibited greater chronic mental illness, treatment use, physical health problems, and functional impairment compared to single-disorder cases.
    • Single-disorder cases were more impaired than non-disordered cases, but comorbid cases showed the most severe impairment.
    • Findings highlight the significant impact of comorbidity on adaptation in work, education, health, and social support.

    Conclusions:

    • Samples underrepresenting or overrepresenting comorbidity can skew research findings on disorder correlates.
    • Comorbidity presents significant challenges for treatment planning, patient compliance, and coordinated service delivery.
    • The association of comorbidity with physical, educational, and economic problems underscores its broad societal concern.