COMORBIDITY: INDICES, COMMON COMORBID DISORDERS - PSYCHOLOGY - 2025

The comorbidity is the appearance of a second medical or psychological disorder while a major disease. In the fields of health, whether physical or mental, it is important to study which problems appear together most frequently to prevent their most serious consequences.

There are generally three uses of the word comorbidity. The first and most traditional is to indicate a medical or psychological condition that exists at the same time but independently of another disorder in a patient.

The second use is to signal a problem in a patient that causes, or is caused by, another physical or mental disorder. Finally, the most general use is to indicate two disorders that exist at the same time, regardless of whether there is a causal relationship between them or not.

Especially in medicine, several tests or "indices" have been developed to see the danger that comes with the appearance of various comorbid disorders.

Each of them tries to look at the likelihood that the occurrence of several disorders together will lead to death or other especially worrisome outcomes.

Comorbidity indices

Comorbidity indices are tests that try to study the risk of two or more diseases when they appear together.

They are used especially in the field of medicine. Today, there is not one that is accepted by the entire scientific community, but several are usually used depending on the situation.

Charlson index

It is the most widely used comorbidity index. It is used to predict the probability of death within a year for patients who have certain comorbid conditions.

For example, heart problems, cancer, or AIDS. Each disease is assigned a 1, 2, 3, or 6, depending on the risks involved.

Later, the scores for all diseases present are added together to predict mortality. Next we will look at some of the most common disorders.

Level 1

Severe but not life-threatening illnesses are included at this level. For example, diabetes, heart attack, chronic organ disease, or dementia.

Level 2

Diseases of this level carry more risk than those of level 1, but are still curable. These include, but are not limited to, leukemia, hemiplegia, moderate or severe kidney problems, or tumors.

Level 3

Level 3 includes very serious problems, which are not easily curable. For example, diseases that severely affect the liver.

Level 6

Level 6 diseases cannot be cured at this time. However, they can usually be treated. Among others, this includes AIDS, malignant tumors, and metastatic cancer.

For clinicians, this index is helpful in determining the best course of action to take. Sometimes it is not clear which of the diseases needs to be treated first. The Charlson index can help you choose between several possible treatments.

Comorbidity and polypharmacy score (CPS)

This index is a simple way to measure the impact and possible risk of diseases present in a patient. It is a simple sum of all known medical conditions in the person, as well as all types of medication that it is necessary for them to take.

The idea behind CPS is that the more medication a person needs, the more severe their illnesses will be. In practice, this comorbidity index has been shown to predict with considerable validity levels of mortality, relapses in disorders, and the appearance of new ones.

Common comorbid disorders

Below you will find a list of some of the disorders that occur at the same time in most cases, both in the medical and psychological fields.

Diabetes

Diabetes is one of the most widespread diseases in the modern world. At the same time, it is one of the highest cases of comorbidity.

In some cases, the disorders with which it appears are directly related to it, while in others the relationship is not causal.

Thus, for example, 67% of people with type II diabetes also have hypertension problems. Among the patients with this subtype of the disease, in addition, 27% were overweight and 61% were obese.

On the other hand, although the exact percentages of comorbidity are not known, it is known that diabetes usually occurs with other disorders such as cancer, depression, sleep problems or kidney difficulties.

AIDS

AIDS is one of the most serious modern diseases that exist. If left untreated, the mortality rate is practically 100%. On the other hand, even with the help of proper therapy, patients with this disorder often have all kinds of health complications.

For example, it is known that the presence of chronic AIDS increases the chances of suffering from other diseases such as cardiovascular accidents, osteoporosis or kidney failure. To a lesser extent, it could also cause hypertension and endocrine diseases.

Depression

Of all the mental disorders, depression is one of the most common and also one of the most dangerous. One of the main reasons is that it has a high rate of comorbidity, both with other psychological illnesses and with some of physical origin.

Thus, people with major depression tend to have higher rates of anxiety-related disorders than the general population. Among others, they may present symptoms of obsessive-compulsive disorder, generalized anxiety, social phobia or panic attacks.

On the other hand, depression tends to appear more frequently in patients with serious physical illnesses. For example, this is the case for those who have cancer, heart problems or AIDS.

Anxiety disorders

The term "anxiety" is commonly used to describe the symptoms of a multitude of different psychological disorders. However, these are problems with very different consequences.

In the case of these disorders, comorbidity is especially high. Thus, for example, a person with post-traumatic stress disorder has a high probability of developing agoraphobia.

In the same way, someone with generalized anxiety might also have intrusive thoughts, more typical of obsessive-compulsive disorder.

References

1. "Comorbidity" in: Wikipedia. Retrieved on: June 19, 2018 from Wikipedia: es.wikipedia.org.
2. "Management of Common Comorbidities of Diabetes" at: AACE Diabetes Resources Center. Retrieved on: June 19, 2018 from AACE Diabetes Resources Center: outpatient.aace.com.
3. "Co-morbidities are common and rising among people with HIV in the US" in: Aidsmap. Retrieved on: June 19, 2018 from Aidsmap: aidsmap.com.
4. "The Comorbidity of Major Depression and Anxiety Disorders: Recognition and Management in Primary Care" in: National Center for Biotechnology Information. Retrieved on: June 19, 2018 from the National Center for Biotechnology Information: ncbi.nlm.nih.gov.
5. "Can You Have Comorbid Anxiety Disorders?" at: Calm Clinic. Retrieved on: June 19, 2018 from Calm Clinic: calmclinic.com.