Thursday, March 8, 2012 6 Comments
Cormorbid or Co-occuring?
by Madelyn Griffith-Haynie, CTP, CMC, ACT, MCC, SCAC
Wait! Doesn’t comorbid mean
Not exactly. Comorbidity refers to a specific KIND of “co-occurance.”
A comorbid disorder refers to additional conditions or syndromes or disorders frequently found in a specific diagnostic population.
In other words, we’re talking about accompanying conditions that are not part of the diagnostic criteria for the “main” condition, but are frequently seen in that particular population of individuals.
From a behavioral standpoint, these additional conditions occur sometimes with similar or overlapping symptoms, and sometimes they show up with additional symptoms – those not necessarily seen in those with the original or “base” diagnosis.
The overlap may reflect a causal relationship between the two diagnoses, and they may relect an underlying vulnerability in common, but the important concept is that they co-occur more frequently in our “target population” than in population norms otherwise, and to a statistically significant degree.
So, even if an entire hotel full of ADDers happens to be diabetic as well, we still would not say their diagnosis was ADD with comorbid diabetes, because the two conditions haven’t been proven to occur in tandem any more frequently than the incidence of diabetes in the general (non-ADD or “vanilla”) population.
So, in this example, the two conditions are co-occuring, NOT comorbid, even though it may not look that way to anyone staying in this particular hotel!
Muddying the waters further, the statistics change depending on which end of the diagnostic telescope you look through. For example, up to 60% percent of children with tic disorders also have ADD, but nowhere near 60% of ADDers have tic disorders.
The high possibility of comorbidities is yet another good reason to make sure you get an excellent differential diagnosis — but the articles in the Comorbidities Series are going to look at some of the diagnoses that frequenly hitch-hike along with ADD through another lens: SUCCESS!
Developing person-specific work-arounds and interventions to help you achieve that blessed state of Optimal Functioning that I believe is our birthright comes through the identifying, understanding, and learning to work with and work around ALL of the “mix-ins” in your particular flavor of ADD:
“Learning to drive the very brain you were born with
– even if it’s taken a few hits in the meantime!”™