NCBISkiptomaincontentSkiptonavigationResourcesHowToAboutNCBIAccesskeysMyNCBISignintoNCBISignOutTryoutPMCLabsandtelluswhatyouthink.LearnMore.JournalListWorldPsychiatryv.3(1);2004FebPMC1414656WorldPsychiatry.2004Feb;3(1):24.PMCID:PMC1414656PMID:16633446DisordersaredifferentfromdiseasesJohnCooper1JohnCooper1MeadowCottage,25IretonGrove,Attenborough,NottinghamNG96BJ,UKFindarticlesbyJohnCooperAuthorinformationCopyrightandLicenseinformationDisclaimer1MeadowCottage,25IretonGrove,Attenborough,NottinghamNG96BJ,UKCopyrightWorldPsychiatricAssociationSeethearticle"Psychiatriccomorbidity:ismoreless?"on page 18.ThisarticlehasbeencitedbyotherarticlesinPMC.Pincusetalcorrectlypointoutthatwhatisoftencalled"theco-morbidityproblem"isunavoidable,becauseitissimplyafactoflifeinclinicalpsychiatry.Theyprovideausefuldiscussionofthetopic,buttheveryuseoftheconventionalterm'co-morbidity'servestohidetherealnatureoftheproblem.Thisisbecause'morbid'meansdisease,andtohaveadiseaseisconceptuallyverydifferentfromsufferingfromadisorder.Strictlyspeaking,theterms'diagnosis'and'disease'arebothbestavoidedinpsychiatricdiscourseunlesstheyarecompletelyjustified.Clinicalpsychiatristsmakefewdiagnosesinthesenseofidentifyingknownabnormalitieswhichunderliethepresentingsymptoms.Instead,formostpatientstheyhavetomakedowithidentifyingdisordersbyassessingthenumberandseverityofindividuallynon-diagnosticsymptomsfromanagreedlist.Mostcurrentlyrecogniseddisordersarenomorethansymptomclusters,andthereisnoparticularreasonwhymostpatientsshouldbeexpectedtohaveonlyoneofthese.Viewedinthisway,itisclearthatitwouldbemorehonestforpsychiatriststouseotherterms,suchas'co-existingdisorders'or'multipledisorders'.Onthebasisofthepointsjustmade,itisnaturaltowonderwhytheinappropriateterm'co-morbidity'hasbecomeacceptedusage.Probablyitisahang-overeffectfromthevitallyimportantgeneralmedicaltrainingthatallpsychiatristsundergo,duringwhichitiseasytodeveloptheexpectationthatmostpatientshaveonlyonediagnosabledisease.Butthingsaredifferentinpsychiatry,and