Statistical issues in assessing comorbidity.

I define three separate and distinct types of non-random comorbidity: epidemiologic, clinical and familial. These might exist singly or in any combination for a pair of disorders. The focus is on their definition and the measurement and interpretation of the types of comorbidity of most common concern: epidemiologic comorbidity. I discuss certain sources of epidemiologic comorbidity such as shared risk factors, or diagnostic 'fuzziness', and I indicate the directions of research design and analyses to disclose such sources.

[1]  A R Feinstein,et al.  THE PRE-THERAPEUTIC CLASSIFICATION OF CO-MORBIDITY IN CHRONIC DISEASE. , 1970, Journal of chronic diseases.

[2]  E Y Deykin,et al.  Adolescent depression, alcohol and drug abuse. , 1987, American journal of public health.

[3]  A measure of 2 x 2 association with stable variance and approximately normal small-sample distribution: planning cost-effective studies. , 1986, Biometrics.

[4]  T. Germanson,et al.  The prevalence of psychiatric disorders in patients with alcohol and other drug problems. , 1988, Archives of general psychiatry.

[5]  M. Schuckit,et al.  Alcoholism, anxiety and depression. , 1988, British journal of addiction.

[6]  K. O'sullivan,et al.  A Comparison of Alcoholics with and without Coexisting Affective Disorder , 1983, British Journal of Psychiatry.

[7]  J. Maser,et al.  Comorbidity of mood and anxiety disorders , 1990 .

[8]  H. Kraemer,et al.  Kappa coefficients in epidemiology: an appraisal of a reappraisal. , 1988, Journal of clinical epidemiology.

[9]  A. Feinstein,et al.  The importance of classifying initial co-morbidity in evaluating the outcome of diabetes mellitus. , 1974, Journal of chronic diseases.

[10]  G. Brown,et al.  Aetiology of anxiety and depressive disorders in an inner-city population. 1. Early adversity , 1993, Psychological Medicine.

[11]  H. Kraemer,et al.  How many raters? Toward the most reliable diagnostic consensus. , 1992, Statistics in medicine.

[12]  T. Berney,et al.  Diagnosing Childhood Depression. Who Should be Interviewed - Parent or Child? , 1991, British Journal of Psychiatry.

[13]  Stephen E. Fienberg,et al.  The analysis of cross-classified categorical data , 1980 .

[14]  L. A. Goodman,et al.  Measures of association for cross classifications , 1979 .

[15]  J. Fleiss Statistical methods for rates and proportions , 1974 .

[16]  Helena C. Kraemer,et al.  Assessment of 2 × 2 Associations: Generalization of Signal-Detection Methodology , 1988 .

[17]  D S Rae,et al.  Epidemiologic evidence for early onset of mental disorders and higher risk of drug abuse in young adults. , 1988, The American journal of psychiatry.

[18]  P. Bickel,et al.  Sex Bias in Graduate Admissions: Data from Berkeley , 1975, Science.

[19]  H. Kraemer The Robustness of Common Measures of 2×2 Association to Bias Due to Misclassifications , 1985 .