Concurrent diagnostic comorbidity is the norm rather than exception. Diagnostic comorbidity rate is so high that some researchers argue for abandoning the term "comorbidity" in favor of a term that is more simply descriptive and does not imply the presence of distinct clinical entities. 

Excessive diagnostic co-occurrence

New cases of major depression disorder and anxiety disorders comorbidity are frequently emerging in primary care settings. There are many reasons why it is important to discover, diagnose, and treat the comorbidity of major depression and anxiety disorders. One of the reasons is that anxiety disorders might not be diagnosed or treated if the possibility of comorbidity is not kept in mind. Another reason is that undiagnosed comorbidity of major depression disorder and anxiety disorders might increase the risk of psychiatric hospitalization, physical illnesses, disability, and even suicide. Furthermore, undiagnosed comorbidity of major depression disorder and anxiety disorders might lessen the effect of treatment and create the need for long-term treatment.

The Comorbidity of Major Depression and Anxiety Disorders: Recognition and Management in Primary Care.

Reference for The Comorbidity of Major Depression and Anxiety Disorders

There are multiple types of comorbidities:
* A type of comorbidity that happens when one disorder leads to the development of the other disorder.
* A type of comorbidity that happens when a genetic predisposition or an underlying causal factor causes the development of two different disorders at the same time. 
* A type of comorbidity in which two independent disorders co-occur at the same time by coincidence.

Types of Comorbidities

A significant comorbidity exists between obsessive-compulsive disorder (OCD) and major depressive disorder. Data shows that 41% of individuals with OCD also meet the diagnostic criteria for major depressive disorder. This relationship is often depicted in a Venn diagram, where the overlapping section of the two disorders' circles represents the percentage of co-occurrence.

Comorbidity of Obsessive-Compulsive Disorder and Major Depressive Disorder

The co-occurrence of multiple disorders, particularly a mental illness alongside a substance use disorder, has significant consequences for the available treatment options and their effectiveness.

Treatment Implications of Comorbidity

Comorbidity refers to the presence of two or more diagnoses in an individual. In the context of addiction, it is common for a person to have both a substance-related disorder and another psychiatric diagnosis, such as depression, bipolar disorder, or schizophrenia. The link is strong; compared to the general population, individuals who misuse illicit or prescription drugs are twice as likely to also suffer from a mood or anxiety disorder.

Comorbidity of Substance Use Disorders and Other Mental Illnesses

Analyze the following clinical scenario and explain the primary challenge it presents for developing an effective treatment plan.

Clinical Treatment Planning

Comorbidity refers to the co-occurrence of two or more distinct disorders in an individual, where the symptoms of each can often interact in negative ways. This is a common phenomenon in psychology, with each disorder presumed to have its own etiology, pathology, and implications for treatment.

University of Illinois at Urbana-Champaign

Trinity College (CT)

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Excessive diagnostic co-occurrence

Boundary disputes

Dilemmas of the categorical model

The DSM-5 is the most recent edition of the DSM. It contains descriptions of each of the major personality disorders and aids in diagnosis disorders. The DSM-5 organizes personality disorders in terms of the maladaptive five traits that go along side the Big 5 personality traits. 

Diagnostic and Statistical Manual (DSM-5)

Widiger, T. A., & Samuel, D. B. (2005). Diagnostic categories or dimensions? A question for the Diagnostic and statistical manual of mental disorders--. Journal of abnormal psychology, 114(4), 494. https://doi.org/10.1037/0021-843X.114.4.494

Diagnostic categories or dimension? A question for the Diagnostic and Statistical Manual of Mental Disorders -- Fifth Edition

Spielman, R. M., Jenkins, W. J., & Lovett, M. D. (2020, April 22). Psychology (2nd ed.). OpenStax. https://openstax.org/books/psychology-2e/pages/1-introduction

OpenStax Psychology (2nd ed.) Textbook

Comorbidity

New diagnoses added to the nomenclature reflect not so much the discovery of a previously unrecognized disease, pathogen, or lesion but are instead to efforts to fill gaps among existing categories. However, these new diagnostic categories can create additional boundary confusions. 

Generalized social phobia

Schizoaffective disorder

Mixed anxiety-depressive disorder

These three diagnoses are examples because they are on the borders of domains of psychopathology that have been regarded as relatively distinct.

Boundary disputes

Evaluate the use of the Diagnostic and Statistical Manual (DSM-5) as the primary tool for diagnosing psychological disorders. In your response, discuss at least one major advantage and one significant criticism of relying on this standardized classification system in a clinical setting.

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