Medical and Psychiatric Comorbidity Over the Course of Life

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Compiled from presentations given at the 2004 American Psychopathological Association (APPA) annual meeting, Medical and Psychiatric Comorbidity Over the Course of Life reviews the comorbidity of mental and chronic physical syndromes in an epidemiological and life course context, offering fresh insights and identifying crucial clues — gleaned from the overlapping areas or areas of mutual pathogenesis linking disparate realms of knowledge — to the etiology and nosological distinctiveness of both physical and mental disorders.

Once relatively ignored, the study of lifetime comorbidity has the potential to suggest etiological clues and to advance our ability to prevent secondary disorders by increasing our knowledge about the course and pathology of the primary disease.

The etiologically relevant period, beginning with the earliest causal action and ending with diagnosis, helps us understand this potential and thus is vital to the study of comorbidity. Divided into five main sections (epidemiology, risk factors, mood disorders, emotions and health, and schizophrenia), Medical and Psychiatric Comorbidity Over the Course of Life discusses critical aspects of the life course characteristics of the etiologically relevant period: • It can be long, e.g., temperament, a relatively enduring emotional predisposition, may situate an individual more or less permanently at high risk, culminating in irreversibility only after decades of induction. The action of identical genes produces different disorders that may occur at different stages of life, such as the comorbidity of panic disorder and cystitis.• It may involve critical stages, i.e., relatively narrow periods during development, such as fetal growth and puberty, to which the action of a given cause is limited. Critical periods of varying durations may exist throughout the course of life.• It may have a cumulative quality to it, in which years or even decades of accumulation are required to reach the point of irreversibility, e.g., the years-long burden of lower class life, or of increased allostatic burden, for the causal nexus to reach sufficiency.• It may involve multiple causes, representing different disciplines and different spheres of action spread throughout the life course.

Medical and Psychiatric Comorbidity Over the Course of Life will prove invaluable for practitioners in general and consultation-liaison psychiatry, family practice and internal medicine, and psychosomatics, behavioral medicine, and health psychology.

American Psychiatric Publishing

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Editorial Reviews

[Medical and Psychiatric Comorbidity Over the Course of Life] serves as an excellent reference of how epidemiological methods work. The methods provide a unique way to study psychological disorders, in their natural context within a population. The book's conclusion, the most compelling of many studies, is that comorbid conditions provide a rich context of relationships between the mind and body.... For many psychologists, the book provides illustrative examples of studying mental illness in ways that may be unfamiliar.
Journal of Clinical Psychiatry
This well-edited collection of studies and reviews examines causal and clinical overlapping of psychiatric and general medical disorders. The material selected is…thoughtful and concise.
Doody's Review Service
Reviewer: Benjamin Ling, DO (Rush University Medical Center)
Description: This is a compilation of presentations at the 2004 annual meeting of the American Psychopathological Association (APPA) that specifically addressed the theme of the relationship between medical and psychiatric illness. The book is compartmentalized into five different sections discussing issues of epidemiology, risk factors, mood disorders, emotions and health, and schizophrenia.
Purpose: The overall purpose is to investigate the current evidence in support of causal relationships (versus mere correlation) between comorbid illnesses. Special focus is placed in the preface and beginning chapters on how epidemiological data may help elucidate complex relationships between genes, environment, psychosocial factors, and the aspects of phenotypic expression.
Audience: It is intended for any members in mental healthcare with an interest in the conceptual framework of lifetime comorbidity. It introduces readers to the important concept of the "etiological relevant period" and its specific characteristics (i.e., duration, intrinsic critical stages, and cumulative quality).
Features: The book introduces in the preface several models for comorbidity that demonstrate the complexity of relationships between risk factors, pathogenesis, primary and secondary conditions, and clinical signs/symptoms. The concept of "pathogenetic interplay" is also described to illustrate the overlap between "risk structure" and pathogenesis. An illustrative example that is discussed is the efficacy studies of Cox-2 inhibitors to shift the balance between Type-l and Type-2 immunity in schizophrenia and its possible clinical consequences.
Assessment: This is an important contribution to the study of medical and psychiatric comorbidity starting from an important primer on life course epidemiology. The wide variety of psychiatric and medical topics serves to demonstrate an expanding and exciting: area of academic inquiry.
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Product Details

  • ISBN-13: 9781585622313
  • Publisher: American Psychiatric Publishing, Incorporated
  • Publication date: 10/28/2005
  • Pages: 320
  • Product dimensions: 6.00 (w) x 9.00 (h) x 1.00 (d)

Meet the Author

William W. Eaton, Ph.D., is Professor and Chair of the Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland.

American Psychiatric Publishing

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Table of Contents

Preface: life course epidemiology and comorbidity. Part I: Epidemiology. Physical and psychiatric illness across adolescence: a life course perspective. The consequences of psychopathology in the Baltimore Epidemiologic Catchment Area follow-up. Part II: Risk Factors. Linking fetal experience to adult disease: examples from schizophrenia. Epidemiological phenotype hunting: panic and interstitial cystitis. Fundamental social causes: the ascendancy of social factors as determinants of distributions of mental illnesses in populations. Part III: Mood Disorders. Mood disorders and the heart. Depression: a major, unrecognized risk factor for osteoporosis? Cognitive impairment and the phenomenology and course of geriatric depression. Part IV: Emotions and Health. Allostasis and allostatic load over the life course. Emotions, personality, and health. Something old, something new, something borrowed, something blue: the story of "Gulf War syndrome." Part V: Schizophrenia. Use of national medical databases to study medical illness and mortality in schizophrenia. COX-2 inhibition in schizophrenia: focus on clinical effects of celecoxib therapy and the role of TNF-α;. Schizophrenia, metabolic disturbance, and cardiovascular risk. Index.

American Psychiatric Publishing

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