Comorbidity Issues and Treatment in Chronic Mental Illness

Comorbidity Issues and Treatment in Chronic Mental Illness

Deepika Srivastav (Institute of Human Behaviour and Allied Sciences, India) and Tej Bahadur Singh (Central University of South Bihar (CUSB), India)
DOI: 10.4018/978-1-5225-0519-8.ch005
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Abstract

Comorbidity refers to presence of one or more additional disorders along with a primary disorder. It affects the prognosis and course of treatment. It is often difficult for clinician to make correct diagnosis in presence of various disorders. The clinical picture of various disorders interferes with treatment process and the outcome. There are some disorders in psychiatry, known as chronic illness. These are schizophrenia, bipolar disorder and obsessive-compulsive disorder. All these three disorder have a major effect on individual's life. Anxiety, depression, substance abuse and panic symptoms are common in schizophrenia; hence the clinical picture changes frequently. While the literature suggests that presence of two or three disorders make treatment worse, hence multidisciplinary treatment need to be used.
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Schizophrenia

Schizophrenia is a cluster of disorders that alters an individual’s thoughts, perception, affect and behaviour. The concept of schizophrenia was formulated by the work of Benedict-Auguste Morel and Karl Kahlbaum in the mid-nineteenth century (Shorter, 1997). The term ‘Demence Precoce’ was coined by Auguste Morel to define a disorder characterized by cognitive impairments and progressive deterioration observed in young people. The detailed description of schizophrenia was highlighted by Emil Kraepelin. He suggested that the illness begins at an early age (‘praecox’) and have a relatively chronic course that is characterized by cognitive and social impairment (‘dementia’). In 1857 he proposed that the pathognomic symptom of schizophrenia is fragmenting of the thinking. Hedivided symptoms into two groups i.e., fundamental and secondary group. Kurt Schneider proposed first rank symptoms that are characterized by loss of autonomy, such as thought insertion or delusions of being controlled by outside forces (Fish, 1967).

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