- Life and Medical Sciences Psychiatry Health Sciences
- Dewit, David J. BedirhanÜstÜn, T. Wittchen, Hans-Ulrich Bedirhan Ustun, T. Berglund, Patricia A. Kessler, Ronald C. Wang, Philip S.
- Department of Health Care Policy, Harvard Medical
School, Boston MA, USA Department of Health Care Policy, Harvard
Medical School, 180 Longwood Avenue, Boston, MA
02115. Social, Prevention and Health Policy Research
Department, Centre for Addiction and Mental Health, London,
Ontario, Canada, and Department of Epidemiology and Biostatistics,
University of Western Ontario, London, Ontario,
Canada Assessment, Classification and Epidemiology Group,
World Health Organization, Geneva, Switzerland Department of Health Care Policy, Harvard Medical
School, Boston MA, and Division of Pharmacoepidemiology and
Pharmacoeconomics, Brigham and Women's Hospital Boston MA,
USA Institute of Clinical Psychology and Psychotherapy,
Technical University of Dresden, and Max Planck Institute of
Psychiatry, Munich, Germany Institute for Social Research, University of
Michigan, Ann Arbor MI, USA
- John Wiley&Sons, Ltd.
- 97210 bytes
- 3118 bytes
- Estimation of comparative disease burden in
epidemiological surveys is complicated by the fact that high
comorbidities exist among many chronic conditions. The easiest way
to take comorbidity into consideration is to distinguish between
pure and comorbid conditions and to evaluate the incremental
effects of comorbid conditions in prediction equations. This
approach is illustrated here in an analysis of the effects of pure
and comorbid major depression (MD) and generalized anxiety disorder
(GAD) on a number of different measures of role impairment in the
US National Comorbidity Survey (NCS) and the Mental Health
Supplement to the Ontario (Canada) Health Survey (the Supplement).
Pure MD and pure GAD were found to have roughly equal independent
associations with role impairments. The incremental effects of
having comorbid MD and GAD were found to vary depending on the
outcome under investigation. The paper closes with a discussion of
the methodological complexities associated with generalizing to
comorbidities that involve rare conditions or more than two
disorders. Copyright © 2002 Whurr Publishers Ltd.
- John Wiley & Sons, Ltd.
- Instructions in case access is denied
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