Medical and Psychiatric Comorbidity Over the Course of Life
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.
- Preface: Life course epidemiology and comorbidity
- Part I: Epidemiology
- Chapter 1. Physical and psychiatric illness across adolescence: a life course perspective
- Chapter 2. The consequences of psychopathology in the Baltimore Epidemiologic Catchment Area follow-up
- Part II: Risk Factors
- Chapter 3. Linking fetal experience to adult disease: examples from schizophrenia
- Chapter 4. Epidemiological phenotype hunting: panic and interstitial cystitis
- Chapter 5. Fundamental social causes: the ascendancy of social factors as determinants of distributions of mental illnesses in populations
- Part III: Mood Disorders
- Chapter 6. Mood disorders and the heart
- Chapter 7. Depression: a major, unrecognized risk factor for osteoporosis?
- Chapter 8. Cognitive impairment and the phenomenology and course of geriatric depression
- Part IV: Emotions and Health
- Chapter 9. Allostasis and allostatic load over the life course
- Chapter 10. Emotions, personality, and health
- Chapter 11. Something old, something new, something borrowed, something blue: the story of Gulf War syndrome
- Part V: Schizophrenia
- Chapter 12. Use of national medical databases to study medical illness and mortality in schizophrenia
- Chapter 13. COX-2 inhibition in schizophrenia: focus on clinical effects of celecoxib therapy and the role of TNF-;
- Chapter 14. Schizophrenia, metabolic disturbance, and cardiovascular risk
About the Authors
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.
In short, I think the book is an excellent text that covers the very interesting concept of comorbidity. The book definitely fills a niche and takes a unique perspective. In all my previous experience with the editor, I have found him to be thoughtful and comprehensive. In this case, he does not disappoint.—Michael R. Clark, M.D., M.P.H., Associate Professor and Director, Chronic Pain Treatment Programs, Department of Psychiatry and Behavioral Sciences, The Johns Hopkins Medical Institutions
[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.—PsycCRITIQUES, 1/1/2006
Overall the book succeeds in its mission to acquaint the reader, from a variety of perspectives, with the advantages and limitations of life-course epidemiology as a powerful tool to discover the nature of the relationships between medical and psychiatric disorders.—JAMA, 1/1/2006
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.—Doody's Book Review Service, 1/1/2006
The strength of this [Medical and Psychiatric Comorbidity Over the Course of Life] resides in its readable accounts of the concepts underpinning complex lines of research, examples being investigation of links between foetal experience and the pathogenesis of schizophrenia, and between depression and bone loss and osteoporosis. Risk factors, emotions and health, and other aspects of mood disorders and schizophrenia are also covered. As might be expected, the contributions introduce many 'new' concepts – allostasis, translational and reverse translational research, postmodern illness, and the fundamental social causes hypothesis, to cite a few. I found the discussion of putative autoimmune and metabolic mediation of physical comorbidities of schizophrenia of particular interest.For specialists interested primarily in borderline personality disorder and in psychoanalytic methods, the book is reassuring and informative—British Journal of Psychiatry, 1/1/2006
This well-edited collection of studies and reviews examines causal and clinical overlapping of psychiatric and general medical disorders. The material selected isthoughtful and concise.—Journal of Clinical Psychiatry, 1/1/2006
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