Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 624 North Broadway, Baltimore, MD, 21205, USA.
Graduate Training Program in Clinic Investigation, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
Soc Psychiatry Psychiatr Epidemiol. 2023 Jan;58(1):141-151. doi: 10.1007/s00127-021-02184-9. Epub 2021 Nov 24.
Psychiatric comorbidity is defined as the joint occurrence of two or more mental or substance use disorders. Widespread psychiatric comorbidity has been reported in treatment and population-based studies. The aim of this study was to measure the extent and impact of psychiatric comorbidity in a cohort of the Baltimore Epidemiologic Catchment Area study.
We examined the comorbidity burden of 16 mental disorders in a cohort of 847 participants using both established and novel analytical approaches The Comorbidity to Diagnosis Inflation Ratio (CDIR), is a statistical instrument that quantifies impact of pairwise comorbid associations, both on the whole sample, as well as on each specific disorder.
Most anxiety disorders had substantial co-occurrence with each other, as well as with Major Depressive Disorder (MDD). In addition, mood disorders had a high degree of comorbidity with Alcohol Dependence (AD). The CDIR for the whole sample was 1.32, indicating a ratio of 132 comorbidities per 100 diagnoses. The conditions with high sample prevalence were relatively less comorbid than the low prevalence conditions. Obsessive Compulsive Disorder had a comorbidity burden that was 89% greater than the overall sample.
Anxiety disorders are highly interrelated, as well as highly comorbid with depression. The comorbidity phenomenon is linked to the differential prevalence of the analyzed conditions. Comorbidity frequency (most prevalent comorbid condition) appears mutually exclusive to comorbidity burden (most widely interrelated condition). While AD and MDD were the most frequently diagnosed disorders; low prevalence conditions as OCD and GAD were the most widely interrelated.
精神共病被定义为两种或多种精神或物质使用障碍的共同发生。在治疗和基于人群的研究中广泛报道了精神共病。本研究的目的是测量巴尔的摩流行病学捕获区研究队列中精神共病的程度和影响。
我们使用既定和新颖的分析方法，检查了 847 名参与者中 16 种精神障碍的共病负担。共病诊断膨胀比 (CDIR) 是一种统计工具，可量化成对共病关联对整个样本以及每个特定疾病的影响。
大多数焦虑症彼此之间以及与重度抑郁症 (MDD) 有很大的共同发生。此外，情绪障碍与酒精依赖 (AD) 有很高的共病性。整个样本的 CDIR 为 1.32，表明每 100 个诊断中有 132 种共病。具有高样本患病率的疾病比低患病率的疾病共病程度更高。强迫症的共病负担比整个样本高 89%。
焦虑症之间高度相关，与抑郁症也高度共病。共病现象与分析条件的差异患病率有关。共病频率（最常见的共病情况）似乎与共病负担（最广泛相关的情况）相互排斥。虽然 AD 和 MDD 是最常诊断的疾病；但 OCD 和 GAD 等低患病率疾病是最广泛相关的。
