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Comorbidity (Psycho) Analysed

Published online by Cambridge University Press:  06 August 2018

H. M. Van Praag*
Affiliation:
Department of Psychiatry, State University of Limburg, P. Debyelaan 25, Postbus 5800, 6202 AZ Maastricht, Netherlands

Abstract

Many psychiatric patients seem to suffer from a multitude of psychiatric disorders. The term comorbidity' was introduced to characterise that situation. This term, however, is multi-interpretable and thus conceals more than it clarifies. Five interpretations of the concept of comorbidity are discussed, in conjunction with the consequences their validity would have for psychiatric research, in particular for the biological branch. If the term comorbidity continues to be used without further qualification, it will slow down the process of conceptualisation of novel research strategies in experimental psychiatry, which is so urgently needed.

Type
Research Article
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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References

Baer, L., Jenike, M. A., Black, D. W., et al (1992) Effect of axis II diagnoses on treatment outcome with clomipramine in 55 patients with obsessive–compulsive disorder. Archives of General Psychiatry, 49, 862866.CrossRefGoogle ScholarPubMed
Benkert, O., Wetzel, H. & Szegedi, A. (1993) Serotonin dysfunction syndromes: a functional common denominator for classification of depression, anxiety, and obsessive–compulsive disorder. International Clinical Psychopharmacology, 8 (suppl. 1), 314.CrossRefGoogle ScholarPubMed
Bleich, A., Brown, S. L., Kahn, R. S., et al (1988) The role of serotonin in schizophrenia. Schizophrenia Bulletin, 14, 297315.CrossRefGoogle ScholarPubMed
Bleuler, E. (1922) Lehrbuch der Psychiatric Vierte Auflage. Berlin: Verlaq von Julius Springer.Google Scholar
Caldecott-Hazard, S., Guze, B. H., Kling, M. A., et al (1991) Clinical and biochemical aspects of depressive disorders: I. Introduction, classification, and research techniques. Synapse, 8, 185211.CrossRefGoogle ScholarPubMed
Coccaro, E. F. & Siever, L. J. (1985) Second generation antidepressants: a comparative review. Journal of Clinical Pharmacology, 25, 241260.CrossRefGoogle ScholarPubMed
Delgado, P. L., Charney, D. S., Price, L. H., et al (1990) Serotonin function and the mechanism of antidepressant action. Archives of General Psychiatry, 47, 411418.CrossRefGoogle ScholarPubMed
Gitlin, M. J. (1993) Pharmacotherapy of personality disorders: conceptual framework and clinical strategies. Journal of Clinical Psychopharmacology, 13, 343353.CrossRefGoogle ScholarPubMed
Hollister, L. E. & Claghorn, J. L. (1993) New antidepressants. Annual Reviews of Pharmacology and Toxicology, 32, 165177.CrossRefGoogle Scholar
Kahn, R. S. & van Praag, H. M. (1992) Panic disorder: a biological perspective. European Neuropsychopharmacology, 2, 120.CrossRefGoogle ScholarPubMed
Meyer, A. (1957) Psychobiology: A Science of Man. Springfield, IL: Charles C. Thomas.Google Scholar
Ohuoha, D. C., Hyde, T. M. & Kleinman, J. E. (1993) The role of serotonin in schizophrenia: an overview of the nomenclature, distribution and alterations of serotonin receptors in the central nervous system. Psychopharmacology, 112, S5S15.CrossRefGoogle ScholarPubMed
Reich, J. H. & Vasile, R. G. (1993) Effect of personality disorders on the treatment outcome of axis I conditions: an update. Journal of Nervous and Mental Disease, 181, 475484.CrossRefGoogle ScholarPubMed
Siever, L. J., Kahn, R. S., Lawlor, B. A., et al (1991) Critical issues in defining the role of serotonin in psychiatric disorders. Pharmacological Reviews, 43, 509525.Google ScholarPubMed
Song, F., Freemantle, N., Sheldon, T. A., et al (1993) Selective serotonin reuptake inhibitors: meta-analysis of efficacy and acceptability. British Medical Journal, 306, 683687.CrossRefGoogle ScholarPubMed
Tyrer, P., Seivewright, N., Ferguson, B., et al (1993) The Nottingham study of neurotic disorder. Effect of personality status on response to drug treatment, cognitive therapy and self-help over two years. British Journal of Psychiatry, 162, 219226.CrossRefGoogle ScholarPubMed
van Praag, H. M. (1990) Two-tier diagnosing in psychiatry. Psychiatric Research, 34, 111.CrossRefGoogle ScholarPubMed
van Praag, H. M. (1991) Serotonergic dysfunction and aggression control. Psychological Medicine, 21, 1519.CrossRefGoogle ScholarPubMed
van Praag, H. M. (1992a) Make Believes in Psychiatry of the Perils of Progress. New York: Brunner Mazel.Google Scholar
van Praag, H. M. (1992b) About the centrality of mood lowering in mood disorders. European Neuropsychopharmacology, 2, 393402.CrossRefGoogle ScholarPubMed
van Praag, H. M. (1992c) Reconquest of the subjective. Against the waining of psychiatric diagnosing. British Journal of Psychiatry, 160, 266271.CrossRefGoogle Scholar
van Praag, H. M. (1993) Diagnosis, the rate-limiting factor of biological depression research. Neuropsychobiology, 28, 197206.CrossRefGoogle ScholarPubMed
van Praag, H. M. (1995a) Serotonin-related, anxiety/aggression-driven stressor-precipitated depression. A psycho-biological hypothesis. European Psychiatry, in press.CrossRefGoogle Scholar
van Praag, H. M. (1995b) Concerns about depressions. European Psychiatry, 10, 269275.CrossRefGoogle Scholar
van Praag, H. M. (1996) Over the mainstream. Diagnostic requirements for biological psychiatric research. European Psychiatry, in press.CrossRefGoogle Scholar
van Praag, H. M., Kahn, R., Asnis, G. M., et al (1987) Denosologization of biological psychiatry or the specificity of 5-HT disturbances in psychiatric disorders. Journal of Affective Disorders, 13, 18.CrossRefGoogle Scholar
van Praag, H. M., Asnis, G. M., Kahn, R. S., et al (1990) Monoamines and abnormal behaviour. A multi-aminergic perspective. British Journal of Psychiatry, 157, 723734.CrossRefGoogle ScholarPubMed
Wade, S. L., Monroe, S. M. & Michelson, L. K. (1993) Chronic life stress and treatment outcome in agoraphobia with panic attacks. American Journal of Psychiatry, 150, 14911495.Google ScholarPubMed
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