Expanded conceptualization of multimorbidity to encompass substance use disorders and other psychiatric illness

Carol S North, Edson S Brown, David E. Pollio

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

BACKGROUND: Traditionally, the study of medicine has focused on individual diseases. In reality, however, diseases tend to co-occur in individual patients, a concept known as multimorbidity. Multimorbidity most often is seen in geriatric practice. Empirical data on patients with multiple chronic disorders and clinical care guidelines based on single conditions are insufficient to inform medical care of patients with >1 medical condition.

METHODS: This article reviews concepts of multimorbidity in the published literature in the context of substance use disorders, other psychiatric disorders, and associated social and environmental problems in other populations, including public sector service populations.

RESULTS: Besides historically recognized co-occurrence of 3 dimensions of illness, including multiple medical illnesses, psychiatric disorders, and substance use disorders in varying combinations with one another, a fourth dimension of multimorbidity that includes associated social and environmental conditions fits within this construction.

CONCLUSIONS: Additional steps are needed to address more effectively the needs of patients with substance use and other psychiatric disorders in the public sector psychiatric systems of care. These efforts will need to address the systems theory approach to multimorbidity that entails the socioeconomic and environmental aspects of their conditions.

Original languageEnglish (US)
Pages (from-to)182-188
Number of pages7
JournalAnnals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists
Volume28
Issue number3
StatePublished - Aug 1 2016

Fingerprint

Substance-Related Disorders
Psychiatry
Comorbidity
Public Sector
Systems Theory
Social Conditions
Social Problems
Geriatrics
Population
Patient Care
Medicine
Guidelines

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{ef33d8b413e747598e89a79820100518,
title = "Expanded conceptualization of multimorbidity to encompass substance use disorders and other psychiatric illness",
abstract = "BACKGROUND: Traditionally, the study of medicine has focused on individual diseases. In reality, however, diseases tend to co-occur in individual patients, a concept known as multimorbidity. Multimorbidity most often is seen in geriatric practice. Empirical data on patients with multiple chronic disorders and clinical care guidelines based on single conditions are insufficient to inform medical care of patients with >1 medical condition.METHODS: This article reviews concepts of multimorbidity in the published literature in the context of substance use disorders, other psychiatric disorders, and associated social and environmental problems in other populations, including public sector service populations.RESULTS: Besides historically recognized co-occurrence of 3 dimensions of illness, including multiple medical illnesses, psychiatric disorders, and substance use disorders in varying combinations with one another, a fourth dimension of multimorbidity that includes associated social and environmental conditions fits within this construction.CONCLUSIONS: Additional steps are needed to address more effectively the needs of patients with substance use and other psychiatric disorders in the public sector psychiatric systems of care. These efforts will need to address the systems theory approach to multimorbidity that entails the socioeconomic and environmental aspects of their conditions.",
author = "North, {Carol S} and Brown, {Edson S} and Pollio, {David E.}",
year = "2016",
month = "8",
day = "1",
language = "English (US)",
volume = "28",
pages = "182--188",
journal = "Annals of Clinical Psychiatry",
issn = "1040-1237",
publisher = "Dowden Health Media,Inc",
number = "3",

}

TY - JOUR

T1 - Expanded conceptualization of multimorbidity to encompass substance use disorders and other psychiatric illness

AU - North, Carol S

AU - Brown, Edson S

AU - Pollio, David E.

PY - 2016/8/1

Y1 - 2016/8/1

N2 - BACKGROUND: Traditionally, the study of medicine has focused on individual diseases. In reality, however, diseases tend to co-occur in individual patients, a concept known as multimorbidity. Multimorbidity most often is seen in geriatric practice. Empirical data on patients with multiple chronic disorders and clinical care guidelines based on single conditions are insufficient to inform medical care of patients with >1 medical condition.METHODS: This article reviews concepts of multimorbidity in the published literature in the context of substance use disorders, other psychiatric disorders, and associated social and environmental problems in other populations, including public sector service populations.RESULTS: Besides historically recognized co-occurrence of 3 dimensions of illness, including multiple medical illnesses, psychiatric disorders, and substance use disorders in varying combinations with one another, a fourth dimension of multimorbidity that includes associated social and environmental conditions fits within this construction.CONCLUSIONS: Additional steps are needed to address more effectively the needs of patients with substance use and other psychiatric disorders in the public sector psychiatric systems of care. These efforts will need to address the systems theory approach to multimorbidity that entails the socioeconomic and environmental aspects of their conditions.

AB - BACKGROUND: Traditionally, the study of medicine has focused on individual diseases. In reality, however, diseases tend to co-occur in individual patients, a concept known as multimorbidity. Multimorbidity most often is seen in geriatric practice. Empirical data on patients with multiple chronic disorders and clinical care guidelines based on single conditions are insufficient to inform medical care of patients with >1 medical condition.METHODS: This article reviews concepts of multimorbidity in the published literature in the context of substance use disorders, other psychiatric disorders, and associated social and environmental problems in other populations, including public sector service populations.RESULTS: Besides historically recognized co-occurrence of 3 dimensions of illness, including multiple medical illnesses, psychiatric disorders, and substance use disorders in varying combinations with one another, a fourth dimension of multimorbidity that includes associated social and environmental conditions fits within this construction.CONCLUSIONS: Additional steps are needed to address more effectively the needs of patients with substance use and other psychiatric disorders in the public sector psychiatric systems of care. These efforts will need to address the systems theory approach to multimorbidity that entails the socioeconomic and environmental aspects of their conditions.

UR - http://www.scopus.com/inward/record.url?scp=85032866202&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85032866202&partnerID=8YFLogxK

M3 - Article

VL - 28

SP - 182

EP - 188

JO - Annals of Clinical Psychiatry

JF - Annals of Clinical Psychiatry

SN - 1040-1237

IS - 3

ER -