Comorbidity, psychiatric diagnosis and the Person-centered Integrative Diagnostic Model

Abstract

Clinical comorbidity has increasingly become a defining reality of presenting health needs, the frequency of which is expected to increase in an aging world population affecting developing and developed countries alike. Clinical comorbidities are the rule and not the exception in regular clinical care settings and are associated with increased morbidity, mortality and overall economic and humanitarian burden. Comorbidity within psychiatry presents additional challenges related to the limited nosological validity of psychiatric diagnoses. The challenges of clinical comorbidity require a comprehensive and integrated approach to diagnosis and care. Patient-centered, holistic, community-oriented and comprehensive approaches, as opposed to a narrow, single-disease, acute care model, are critical to addressing the challenges and complexities of clinical comorbidities. The growing challenges of comorbidity underscore the importance of integrating psychiatric, medical and contextual healthcare models within primary care in its various manifestations around the world. Person-centered Integrated Diagnosis (PID) emphasises the totality of the person’s health in an integrative and dynamic approach that is inclusive of both ill and positive health along three fundamental axes promising to provide an optimal model of care to address the challenges of clinical comorbidity.