Have you ever looked up a disability or disorder and found that on the webpage, other disorders or medical conditions were listed as possibly being related to it? That’s because researchers and health professionals have found that some people with certain disabilities and disorders may experience other complications or illnesses. This may be a direct result of their disability, due to challenges in maintaining their health and physical activity, or for reasons we do not yet understand. You may find the words comorbidity or co-occurrence used to describe this phenomenon.
What is a comorbidity?
According to the Centers for Disease Control and Prevention, a comorbidity “occurs when a person has more than one disease or condition at the same time. Conditions described as comorbidities are often chronic or long-term conditions.” Some disorders are linked or may present in a person due to another diagnosis they have. Comorbidities may influence a person’s prognosis or treatment for illness. An example of this is diabetes and chronic kidney disease. Roughly 1 in 3 people with diabetes have chronic kidney disease. Another example is bone loss after spinal cord injury (SCI). According to the Model Systems Knowledge Translation Center, bone loss, or osteoporosis, is extremely common in the first two years after SCI. Studying the comorbidities of disabilities and disorders is important so that people with disabilities and their physicians can anticipate the risks they may develop potentially life-threatening conditions. Armed with this knowledge, a physician may recommend someone with diabetes to regularly have their kidney function screened. Diabetes has other comorbidities as well, such as cardiovascular disease and vision impairment. So, one person’s treatment plan for diabetes and chronic kidney disease may differ significantly from another person who also has diabetes but a history of stroke. Similarly, a patient with SCI may work with his care team to get regular bone density scans, manage intake of key nutrients, and add weight-bearing exercise to his daily routine to avoid a bone fracture.
What is a co-occurrence?
In the medical literature, you may find that words comorbidity and co-occurrence are used interchangeably. However, in the psychiatry and mental health fields you may find a slight difference in meaning between comorbidity and co-occurrence. A co-occurrence may be used to describe a person having a mental health disorder along with a substance use disorder. A 2019 national survey on Drug and Health from the Substance Abuse and Mental Health Services Administration (SAMHSA) 2019 National Survey on Drug Use and Health, found that almost 50% of individuals with a serious mental illness reported engaging in drug or alcohol abuse and the term co-occurrence is used to describe this relationship. Another example of co-occurrence could be a person with depression also having an alcohol use disorder, or someone with anxiety also having opioid use disorder. Co-occurring disorders, according to SAMHSA, are very common and can affect any person at any age.
Studies on common comorbidities and co-occurrences for physical and mental health conditions are powerful tools that can help individuals better understand their health. These studies can help us understand what factors contribute to developing a comorbidity or co-occurring condition, who is at highest risk, and how it can be avoided. By knowing and anticipating possible risk factors associated with certain disabilities and common chronic illnesses and mental health disorders, we can make more informed decisions in our treatment and health choices.
Comorbidity and Co-occurrence Research In Focus
NARIC’s Research In Focus series has highlighted recent NIDILRR-funded research in comorbidities and co-occurring conditions:
- People with Traumatic Brain Injury May Be More Likely to Use Prescription Opioids and at Higher Risk for Opioid Misuse
- People with Childhood Disabilities May Be at Higher Risk for Chronic Diseases as Young Adults
- Adults with Cerebral Palsy May Have Elevated Risk of Some Mental Health Disorders
- Being Overweight or Obese May be Linked to Poorer Health for People with Traumatic Brain Injuries
- Exercise Training or a High-Protein Diet May Improve Insulin Sensitivity in People with Long-Standing Spinal Cord Injury
- Young Men with Spinal Cord Injury May Benefit from Testosterone Screening
- People with Serious Mental Illness May Be at Risk for Obesity and Diabetes
More resources to learn about comorbidity and co-occurrence:
Model Systems Knowledge Translation Center offers information resources for people with SCI, traumatic brain injury, and burn injury and their care teams to manage their health and wellness.
The Center for Health and Self-Directed Care has several tools to help people with psychiatric disabilities manage their health and wellness, including diabetes prevention and smoking cessation programs.
Articles from the National Library of Medicine: