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Comorbidity In Psychiatric Disorders: A Literature Review

Comorbidity In Psychiatric Disorders: A Literature Review

Depression in Parkinson’s disease: diagnosis and management. Latoo J, Mistry M, Dunne FJ. Br J Hosp Med (Lond). 2012;73:331-334.
Parkinson disease has a high prevalence of psychiatric comorbidity, including depression. In this review, Latoo and colleagues highlight the epidemiology, etiology, and diagnosis of depression in patients with Parkinson disease. They provide recommendations on treatment and suggest that a closer partnership between neurology and psychiatry might improve outcomes.

Factors affecting hospital stay in psychiatric patients: the role of active comorbidity. Douzenis A, Seretis D, Nika S, et al. BMC Health Serv Res. 2012;12:166.
Douzenis and colleagues looked at physical comorbidity in psychiatric inpatients using the criterion of referral to medical subspecialties. The study was made up of 200 patients with schizophrenia and 228 patients with bipolar disorder (type I or II). The most common medical comorbidity for patients with bipolar disorder was arterial hypertension; for patients with schizophrenia, it was endocrine/metabolic disease—12% of referrals were for Hashimoto thyroiditis. A positive linear trend was found between length of stay and number of referrals; the effect was greater for schizophrenia patients. The findings suggest that comorbidity that is severe enough to warrant referral is a significant determinant of hospital stay.

Effects of general medical health on Alzheimer’s progression: the Cache County Dementia Progression Study. Leoutsakos JM, Han D, Mielke MM, et al. Int Psychogeriatr. 2012;24:1561-1570.
The goal of this population-based study was to quantify the relationship of incident Alzheimer disease (AD) and to compare global comorbidity ratings with counts of comorbid conditions and medications as predictors of AD progression. The 335 participants with incident AD were followed for up to 11 years. None of the baseline medical variables (general medical health record [GMHR], comorbidities, and nonpsychiatric medications) was associated with differences in rates of decline in longitudinal linear mixed effects models. The findings indicate that it is likely that there is a dynamic relationship between medical and cognitive health. GMHR is a more sensitive measure of health than simple counts of comorbidities or medications.

Depression and epilepsy, pain and psychogenic non-epileptic seizures: clinical and therapeutic perspectives. Kanner AM, Schachter SC, Barry JJ, et al. Epilepsy Behav. 2012;24:169-181.
Is the clinical presentation of depression in people with epilepsy (PWE) unique to this neurological disorder? The high comorbidity of depression and epilepsy may be associated with the existence of common pathogenic mechanisms. Psychogenic nonepileptic seizure (PNES) disorder is often comorbid with depressive disorder. The role of depression in PNES disorder and its treatment are discussed in this article. Data on the treatment of depression in PWE are scarce; thus, clinicians have had to rely on data from patients with primary depressive disorders. A consensus strategy on the identification and treatment of depressive disorders in adult and pediatric patients with epilepsy is outlined in the article.

Epilepsy and psychiatric comorbidity: a nationally representative population-based study. Rai D, Kerr MP, McManus S, Jordanova V, et al. Epilepsia. 2012;53:1095-1103.
Rai and colleagues looked at whether the overrepresentation of comorbidities could be explained by epilepsy being a chronic medical or neurological condition, or by the confounding effect of demographic and socioeconomic factors or other health conditions. The results showed that almost one-third of the people with epilepsy had an ICD-10 anxiety or depressive disorder (compared with 1 in 6 people without epilepsy). Social phobia and agoraphobia, generalized anxiety disorder, depression, and measures of suicidality were strongly associated with epilepsy, which remained robust after accounting for potential confounders. The prevalence of psychiatric and neurodevelopmental conditions was found to be higher in people with epilepsy than in those with other nonneurological chronic conditions.

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