Comprehensive Psychiatry
Volume 47, Issue 4 , Pages 258-264 , July 2006

Comorbidity patterns in routine psychiatric practice: is there evidence of underdetection and underdiagnosis?

  • Joshua E. Wilk

      Affiliations

    • American Psychiatric Institute of Research and Education, Arlington, VA 22209, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1 703 907 8618; fax: +1 703 907 1087.
    • ,
  • Joyce C. West

      Affiliations

    • American Psychiatric Institute of Research and Education, Arlington, VA 22209, USA
    • ,
  • William E. Narrow

      Affiliations

    • American Psychiatric Institute of Research and Education, Arlington, VA 22209, USA
    • ,
  • Steve Marcus

      Affiliations

    • American Psychiatric Institute of Research and Education, Arlington, VA 22209, USA
    • ,
  • Maritza Rubio-Stipec

      Affiliations

    • American Psychiatric Institute of Research and Education, Arlington, VA 22209, USA
    • ,
  • Donald S. Rae

      Affiliations

    • American Psychiatric Institute of Research and Education, Arlington, VA 22209, USA
    • ,
  • Harold A. Pincus

      Affiliations

    • Rand, University of Pittsburgh Health Institute, Pittsburgh, PA 15213, USA
    • ,
  • Darrel A. Regier

      Affiliations

    • American Psychiatric Institute of Research and Education, Arlington, VA 22209, USA

References 

  1. McDermut W, Mattia J, Zimmerman M. Comorbidity burden and its impact on psychosocial morbidity in depressed outpatients. J Affect Disord. 2001;65:289–295
  2. Wolf AW, Schubert DSP, Patterson MB, Marion B, Grande TP. Associations among major psychiatric diagnoses. J Consult Clin Psychol. 1988;56:292–294
  3. Melartin TK, Rytsala HJ, Leskela US, Lestela-Mielonen PS, Sokero TP, Isometsa ET. Current comorbidity of psychiatric disorders among DSM-IV major depressive disorder patients in psychiatric care in the Vantaa Depression Study. J Clin Psychiatry. 2002;63:126–134
  4. Rounsaville BJ, Anton SF, Carrol K, Budde D, Prusoff BA, Gawin F. Psychiatric diagnoses of treatment-seeking cocaine abusers. Arch Gen Psychiatry. 1991;48:43–51
  5. Regier DA, Farmer ME, Rae DS, Locke BZ, Keith SJ, Judd LL, et al. Comorbidity of mental disorders with alcohol and other drug abuse: results from the Epidemiologic Catchment Area (ECA) Study. JAMA. 1990;264:2511–2518
  6. Kessler RC. Epidemiology of psychiatric comorbidity. In:  Tsuang M,  Tohen M,  Zahner G editor. Textbook in psychiatric epidemiology. New York (NY): Wiley-Liss; 1995;p. 179–197
  7. Kessler RC, Foster C, Saunders W, Stang PE. The social consequences of psychiatric disorders, I. Educational attainment. Am J Psychiatry. 1995;152:1026–1032
  8. Forthofer MS, Kessler RC, Story AL, Gotlieb IH. The effects of psychiatric disorders on the probability and timing of first marriage. J Health Soc Behav. 1996;37:121–132
  9. Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders among persons age 15-54 in the United States: results from the National Comorbidity Survey. Arch Gen Psychiatry. 1994;51:8–19
  10. Zimmerman M, Mattia JI. Psychiatric diagnosis in clinical practice: is comorbidity being missed?. Compr Psychiatry. 1999;40:182–191
  11. Pincus HA, Zarin DA, Tanielian TL, Johnson JL, West JC, Pettit AR, et al. Psychiatric patients and treatments in 1997: findings from the American Psychiatric Practice Research Network. Arch Gen Psychiatry. 1999;56:441–449
  12. Zarin DA, Pincus HA, Peterson BD, West JC, Suarez AP, Marcus SC, et al. Characterizing psychiatry with findings from the 1996 National Survey of Psychiatric Practice. Am J Psychiatry. 1998;155:397–404
  13. Narrow WE, Rae DS, Robins LN, Regier DA. Revised prevalence estimates of mental disorders in the United States: using a clinical significance criterion to reconcile 2 surveys' estimates. Arch Gen Psychiatry. 2002;59:115–123
  14. Shah BV, Barnwell BG, Hunt PN, LaVange LM. SUDAAN user's manual, release 7.0. Research Triangle Park (NC): Research Triangle Institute; 1996;
  15. Kessler RC, Wittchen HU, Abelson JM, McGonagle KA, Schwarz N, Kendler KS. Methodological studies of the Composite International Diagnostic Interview (CIDI) in the US National Comorbidity Survey. Int J Methods Psychiatr Res. 1998;7:33–55
  16. Olfson M, Pincus HA. Outpatient mental health care in nonhospital settings: distribution of patients across provider groups. Am J Psychiatry. 1996;153:1353–1356

PII: S0010-440X(05)00106-9

doi: 10.1016/j.comppsych.2005.08.007

Comprehensive Psychiatry
Volume 47, Issue 4 , Pages 258-264 , July 2006

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