Accepting multiple conditions in psychiatry: From comorbidity to multimorbidity.

Christophe Gauld, Emmanuel D’Incau, Pauline Espi, Pierre Fourneret, Aileen McGonigal, Jean-Arthur Micoulaud-Franchi
L'Encéphale. 2024-09-01; :
DOI: 10.1016/j.encep.2024.05.004

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Gauld C(1), D’Incau E(2), Espi P(3), Fourneret P(1), McGonigal A(4),
Micoulaud-Franchi JA(5).

Author information:
(1)Department of Child Psychiatry, CHU de Lyon, 69000 Lyon, France; Institut des
sciences cognitives Marc-Jeannerod, UMR 5229 CNRS & Université Claude-Bernard
Lyon 1, 69000 Lyon, France.
(2)SANPSY, CNRS, UMR 6033, 33076 Bordeaux, France; University of Bordeaux, 33076
Bordeaux, France.
(3)Department of Child Psychiatry, CHU de Lyon, 69000 Lyon, France.
(4)Neurosciences Centre, Mater Hospital, Australia; Queensland Brain Institute,
The University of Queensland, South Brisbane, Australia; Mater Research
Institute, University of Queensland, South Brisbane, Australia.
(5)SANPSY, CNRS, UMR 6033, 33076 Bordeaux, France; University of Bordeaux, 33076
Bordeaux, France. Electronic address: .

The concept of multimorbidity in psychiatry refers to the coexistence of
multiple health conditions without conceptualizing a central disorder referring
to a patient-centered approach that views every diagnosis equally. It emphasizes
a shift from focusing on an index disorder to considering interrelated symptoms
crucial in psychiatry due to frequent multimorbidity patterns. In clinical
practice, multimorbidity guides patient-centered care helping to address the
holistic needs of patients and challenging the organization of mental health
care. In research, multimorbidity reshapes study outcomes and promotes the
development of patient-reported outcome questionnaires, also posing ethical
challenges and advocating for the inclusion of multimorbid patients in
personalized interventions. Finally, multimorbidity in psychiatry has public
health implications aligning with the socioecological systems perspective. This
notion aims to improve prognosis, care, and health costs while impacting global
mortality and challenging the conceptualization and organization of psychiatric
care.