What are comorbidities and how do they affect you?
Comorbidities are coexisting conditions that develop independently of each other. They may share the same risk factors, but they don’t directly cause each other. For example, obesity may increase your risk of developing the comorbidities arthritis and diabetes.
What are the mortality and morbidity associated with morbidly obese patients?
Morbidly obese patients incurred nearly 60% greater observed mortality than normal weight patients. Moreover, morbidly obese patients had greater than 2-fold increase in renal failure and 6.5-fold increase in deep sternal wound infection.
Do patients with comorbid conditions have different outcomes from one diagnosis?
Patients with comorbid conditions have significantly different and more negative outcomes than patients with just one diagnosis. Zimmerman & Chelminski, 2003: compared demographic, clinical, family history and psychosocial characteristics of three independent groups: MDD without GAD, MDD with GAD, and pure GAD.
What are the comorbidities of developmental disorders?
M.J. Snowling, in Encyclopedia of Mental Health (Second Edition), 2016 Comorbidities of developmental disorders are high: having a diagnosis of one developmental disorder increases the likelihood of reaching diagnostic criteria for another disorder. The emphasis in the preceding section was on the co-occurrence of reading and language disorders.
Which of the following is a comorbidity that is recognized to increase the risk for morbidity and mortality in patients with SLE quizlet?
Coronary artery disease is a well-recognized cause of morbidity and mortality among patients with SLE, with autopsy evidence of atherosclerosis in up to 50% of patients.
Does patient with SLE have significant morbidity?
Systemic Lupus Erythematosus (SLE) an autoimmune rheumatic disease with a complex pathogenesis, remains potentially life-threatening. SLE patients have increased morbidity and premature mortality compared to non-SLE patients.
What causes SLE disease?
What causes SLE? The causes of SLE are unknown, but are believed to be linked to environmental, genetic, and hormonal factors.
What is the meaning of SLE disease?
Systemic lupus erythematosus (SLE) is an autoimmune disease. In this disease, the immune system of the body mistakenly attacks healthy tissue. It can affect the skin, joints, kidneys, brain, and other organs.
What are the 3 types of lupus?
There are three types: Acute cutaneous lupus. Chronic cutaneous lupus erythematosus, or discoid lupus erythematosus (DLE) Subacute cutaneous lupus erythematosus.
How is SLE diagnosed?
No one test can diagnose lupus. The combination of blood and urine tests, signs and symptoms, and physical examination findings leads to the diagnosis.
Which client is most likely to develop systemic lupus erythematosus SLE?
Younger women, and especially younger women of color, are most at risk. Sex: Most lupus patients are female. The ratio of women to men who have lupus is about 9 to 1. Race and ethnicity: Women of color have higher incidences of lupus than do White women.
What happens in SLE?
SLE is one of a large group of conditions called autoimmune disorders that occur when the immune system attacks the body's own tissues and organs. SLE may first appear as extreme tiredness (fatigue), a vague feeling of discomfort or illness (malaise), fever, loss of appetite, and weight loss.
Why is SLE called lupus?
Because the location of this rash is the same as the common markings of a wolf, the name "lupus" (wolf in Latin) was given to this disease many years ago. Other skin problems that may happen include large red, circular rashes (plaques), which may scar (called discoid lupus).
What are the 4 types of lupus?
But there are four kinds of lupus:Systemic lupus erythematosus (SLE), the most common form of lupus.Cutaneous lupus, a form of lupus that is limited to the skin.Drug-induced lupus, a lupus-like disease caused by certain prescription drugs.Neonatal lupus, a rare condition that affects infants of women who have lupus.
How is SLE transmitted?
Louis encephalitis (SLE) virus is spread to people through the bite of an infected mosquito. Mosquitoes become infected when they feed on birds that have the virus in their blood. Birds that live in urban-suburban areas, such as the house sparrow, pigeon, blue jay, and robin, are common SLE virus hosts.
Who is affected by lupus?
Lupus strikes mostly women of childbearing age. However, men, children, and teenagers develop lupus, too. Ninety percent (90%) of people living with lupus are women. Most people with lupus develop the disease between the ages of 15-44.
What is lupus morbidity rate?
Over the past 50 years, the survival of patients with SLE has improved significantly. Whereas an earlier study 23 in 1955 reported a survival rate of less than 50% at 5 years, more recent studies 17,21,28,32–34 indicated that over 93% of patients with SLE survive for 5 years, and 85% survive for 10 years.
What is the mortality rate of SLE?
The mortality rate was higher in the SLE group (38.5 per 100,000 person-year) than that in the non-SLE group (13.7 per 100,000 person-year), with an IRR of 2.8 (95% CI, 2.5–3.2). We found that SLE was independently associated with a high mortality rate after adjusting relevant variables (HR 1.47, 95% CI 1.27–1.77).
What is the mortality rate of lupus?
Can people die of lupus? It is believed that between 10-15 percent of people with lupus will die prematurely due to complications of lupus. However, due to improved diagnosis and disease management, most people with the disease will go on to live a normal life span.
What is the prognosis for lupus?
The prognosis of lupus is better today than ever before. With close follow-up and treatment, 80-90% of people with lupus can expect to live a normal life span. It is true that medical science has not yet developed a method for curing lupus, and some people do die from the disease.
How does comorbidity affect the observation of a patient?
The observation of comorbidity between disorders does not in and of itself demonstrate any particular type of relationship between them, least of all causality. Comorbidity can result from many factors. One disorder may represent an early manifestation of another. There may be problems of classification, in which the use of same or similar symptoms define different disorders. Detection artifacts can occur. For example, the presence of one disorder in a patient may make another condition more visible, even though it may be no more common than in a general population. Similarly, the presence of one disorder may influence the observations of clinicians and make them more likely to report the presence of another disorder.
How does psychiatric comorbidity affect epilepsy?
Psychiatric comorbidities impact negatively the quality of life of people with epilepsy and are associated with a worse response to pharmacological and surgical treatment. This chapter reviews the epidemiological, clinical, pathogenic, and therapeutic aspects of psychiatric comorbidities in epilepsy.
What is the role of a therapist in a patient's life?
Therapists approach patients with a certain mindset, reflective of particular schools of therapy but also of generally accepted values, such as empathy, professional responsibility, and the importance of a conceptual framework for diagnosis and treatment. Part of this framework for any therapist today must be the possibility of comorbid disorders in any patient. This point of view, like any other assumption, should be used to enrich and amplify one's view of the patient rather than to unnecessarily codify or stereotype that view. Most data on comorbidity is epidemiologic, although each patient has an individual course of life. In addition, the recognition of an additional problem or disorder does not necessarily require that it be treated, especially in today's climate of focused and time-limited psychotherapies. Still, most therapists have a desire to know as much as they can about their patients' life so as to serve both the patients' needs and enhance their own satisfaction.
What is comorbidity in psychiatry?
Comorbidity is defined as the co-occurence of more than one disorder in the same individual. In its broadest sense, comorbidity can include the co-occurrence of medical and psychiatric disorders, such as the dementia associated with organic conditions or the affective changes resulting from endocrinopathies. In psychiatry, comorbidity is generally taken to mean the association of diagnosable psychiatric disorders. Comorbidity is an epidemiologic phenomenon, relating to the characteristics of a population, and the reported comorbidity of certain disorders in a population does not necessarily imply that they will be comorbid in any given individual. However, observations of comorbidity among populations may be extremely useful in informing the therapist's understanding of an individual patient.
What is the term for the presence of more than one disorder in a person in a specific period of time?
Comorbidity can be defined as the presence of more than one disorder in a person in a specific period of time and could be examined using the “current” or the “lifetime” approach.
Why is comorbidity important in psychiatric patients?
This type of comorbidity is important because it has been demonstrated that it can significantly affect psychiatric treatment outcome. At issue then is whether CPPs as a group demonstrate this type of comorbidity. Unfortunately, this type of comorbidity has also been ignored by pain researchers. There has been only one report that addressed this issue indirectly. In 283 CPPs, 62.3% of the males and 55.1% of the females were assigned an Axis II diagnosis. In the same sample, 94.3% of the males and 95.3% of the females had one or more diagnoses on Axis I. Therefore, it is highly likely that this type of comorbidity is commonly present within CPPs. The exact details of this type of comorbidity have yet to be determined.
What are nonrandom comorbidities?
The first is when one disorder directly effects the onset of a second disorder. For example, persistent alcohol abuse can lead to cirrhosis of the liver. A second class of processes involves indirect effects of one disorder on the onset of a second disorder. The stresses associated with the threat and lifestyle changes that follow from receiving a diagnosis of heart disease, for example, can predispose to the onset of an anxiety disorder. A third class of processes that can lead to comorbidity involves common causes. Traumatic life events, for example, can predispose to a wide range of comorbid anxiety and mood disorders. Biological factors can also be common causes. Twin studies, for example, show that there are common genetic factors that play an important part in bringing about the strong comorbidities found among many commonly occurring mental disorders (Kendler et al. 1995 ).
How can high rates of comorbidity of a large number of disorders be explained?
High rates of comorbidity of a large number of disorders can be explained by alternate expressions of a smaller number of underlying liabilities. There is a broad internalizing liability and an associated broad externalizing liability.
What is the comorbidity between avoidant PD and generalized social phobia?
Comorbidity between General Social Phobia and Avoidant PD is 59% across studies. People with Generalized Social Phobia are more anxious and depressed than people with circumscribed Social Phobia. People with Generalized Social Phobia + Avoidant PD are more depressed and anxious than people with circumscribed SP.
What is a comorbid case?
Comorbid cases are therefore those individuals high on liability one, high on liability 2, or having a mixture of both liabilities.
What is the meaning of having one disorder?
Having one disorder confers risk for another; i.e., the disorder develops not as a result of a specific liability for another disorder, but because of the actual other disorder.
What is the definition of co-occurrence?
Traditional definition: the correlation OR co-occurrence of two or more disorders. The co-occurrence of more than one disorder within an individual Feinstein, 1970. The co-occurrence of two or more disorders with distinct etiologies or, if etiologies are not known, distinct pathophysiology Vella et al., 2000.
What is negative affect?
Negative Affect is a higher order factor seen across anxiety disorders and accounts for overlap with depression. Lower order factors that distinguish each anxiety disorder from others: hyper-arousal specific to panic disorder. Attachment theory/interpersonal models of comorbidity.
Why is the DSM so precise?
The DSM may be too precise in terms of demarcating boundaries between disorders. The DSM may be forcing dimensional disorders into a categorical framework, creating artificial separations of broader symptoms. >Comorbidity could occur due to chance, particularly as the number of disorders in the DSM increases.
Is HPB surgery a major morbidity?
Hepatic, pancreatic, and complex biliary (HPB) surgery can be associated with major morbidity and significant mortality. For the past 5 years, the American College of Surgeons–National Surgical Quality Improvement Program (ACS–NSQIP) has gathered robust data on patients undergoing HPB surgery. We sought to use the ACS–NSQIP data to determine which preoperative variables were predictive of adverse outcomes in patients undergoing HPB surgery.
Is HPB surgery heterogeneous?
While overall morbidity and mortality for HPB surgery are low, peri-operative outcomes are heterogeneous and depend on diagnosis, procedure type, and key clinical factors. By combining these factors, an ACS–NSQIP “HPB Risk Calculator” may be developed in the future to help better risk-stratify patients being considered for complex HPB surgery.
Is hepatopancreato biliary surgery associated with morbidity?
Hepato-pancreato-biliary surgery may be associated with considerable risk of morbidity and mortality . While several single institution studies have reported a reduction in the risk of HPB surgery over time, 2, 4, 5 broad population-based outcomes are less well defined. Data derived from select single centers may not be representative of outcomes at the national level. In addition, publication bias as well as issues with patient selection may confound data from academic centers. Clinicians have uniformly noted that patient selection is a critical element in minimizing adverse outcomes following HPB surgery. Unfortunately, while large administrative datasets provide information on procedural details, many lack information on patient-specific factors and pre-operative medical comorbidities. This may account, in part, for the varied short-term outcomes associated with morbidity and mortality reported in previous studies. 2, 4, 5 A particular strength of the current study was that we were able to define not only the mortality but also the morbidity associated with complex HPB surgery in a broad, nationally representative dataset. Perhaps more importantly, by utilizing the ACS–NSQIP database we were able to examine the effect of both procedure- and patient-specific factors on outcome. Using population-based information on both HPB surgical procedure and patient information provided in the NSQIP dataset, we were able to show that morbidity and mortality varied considerably based not only on the type of surgical procedure and the indication for surgery (e.g., benign vs. malignant) but also pre-operative patient-specific factors. Thirty-day overall and serious morbidity, as well as mortality, were relatively low at 28.4%, 18.6%, and 2.7%, respectively. However, patients with multiple pre-operative risk factors had a markedly higher risk of morbidity and mortality. Specifically, older patients with pre-operative cardiac or pulmonary comorbidities had a risk of morbidity and mortality that were several fold higher than other patients.