Examining Common—and Not-So-Common—Comorbidities

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SPECIAL REPORT: CLINICAL COMPLICATIONS OF COMORBIDITIES

It has been said that textbook cases only exist in textbooks, where the patient presented generally has only 1 condition. This is rarely the case in clinical practice; most patients have more than 1 condition requiring attention.

In some cases, the different conditions do not interact. In many cases, the different conditions interact adversely, or the management of one condition requires careful consideration of the other(s).

Patients may not always provide a complete history, focusing only on the issue that brings them to us. Some patients may think that the other medical or psychiatric issues are unimportant or not anyone’s business.

In this Special Report, we focus on 3 issues of comorbidity that are quite common but not always addressed. Claire E. Koljack, MD, joins Claire C. Holderness, MD, to discuss the often-missed comorbidity of anorexia nervosa and schizophrenia in an older patient. As they note, there is a scant literature on this potentially life-threatening comorbidity.

Perhaps the most common comorbidities involve patients with a variety of personality styles and medical disorders. Everyone has a personality style that can present problems when serious medical illness occurs. Understanding how individuals cope with illness lets us guide our patients through the stress of the illness and medical hospitalization.

There are certainly many other interesting comorbidities that I hope will be addressed in future Special Reports.

Dr Muskin is a professor of psychiatry and senior consultant in consultation-liaison psychiatry at Columbia University Irving Medical Center in New York, New York. He is also a member of the Psychiatric Times Editorial Board.