The health system of today faces an epidemiological shift towards patients with increased comorbidity along with further fragmentation and specialisation of the medical disciplines. These tendencies generate a need for doctors, who can navigate not only within their own field of expertise, but who can secure continuity of care for patients with comorbidity, presenting both mental and physical disorders.
The book aims to raise awareness of the extent and consequences of the co-occurrence of mental and physical disorders. As comorbidity leads to a worse prognosis for both illnesses involved, and as the number of patients with comorbidity is increasing, knowledge of and research within this field is highly relevant. Through an integrative approach, comorbidity and its consequences are investigated from a biopsychosocial perspective and analysed at several levels of health care organisation, from a micro-perspective of individual care to a macro-perspective of public health.
The book is divided into three main sections: the first presents a broad public health perspective on comorbidity of mental and physical illness; the second presents specific major issues of comorbidity; and the last section discusses how the health care system could be organised to meet the challenges of increased comorbidity. The individual contributions are well written and give concise introductions to each their field of research. Two chapters with particularly interesting discussions will be highlighted here. The first chapter offers a discussion on the concept of comorbidity from a static categorical to a dynamic dimensional understanding. Further, it describes the need for medical care to transcend the in-clinic patient–doctor meetings to an integration of clinical, social, organisational and community approaches. The 12th chapter focuses on the role of the general practitioner as pivotal in bringing together the fragmented health care system and securing continuity of care for the patients. Further, the evidence gap for multi-morbidity is described as calling for a new type of research, which embraces the complexity of the patient presenting with multi-morbidity through a shift from purely quantitative to qualitative research.
The book successfully provides a comprehensive introduction to the field of comorbidity in mental and physical disorders and the challenges it brings. The individual chapters bring together a broad range of clinical and preclinical studies and reveal the complexity of the issue. The topics are highly relevant, up to date and well integrated, with good coherence between chapters. The book would make a valuable contribution for general practitioners, internists, psychiatrists and, more generally, people working in the health care system both at an organisational and a practitioner’s level.
