Zusammenfassung
„Komorbidität“ bezieht sich auf die Koexistenz von zwei oder mehr Störungen mit unterschiedlichen, krankheitsspezifischen Ätiologien und Pathophysiologien. Das gemeinsame Vorkommen zweier Syndrome beim selben Patienten kann durch verschiedene Mechanismen zustande kommen, darunter Zufalls- und artifizielle Assoziationen, Selektions-Bias und Mediation durch ein drittes Zustandsbild. Die für Komorbidität verantwortlichen Mechanismen sind bei den verschiedenen Kombinationen von Krankheitsbildern sehr unterschiedlich. Gemeinsame genetische Faktoren sind besonders für einen großen Teil der Exzeßkomorbidität von antisozialer Persönlichkeitsstörung und Alkoholismus verantwortlich. Bei exzessivem Vorkommen von gegenwärtiger oder Lebenszeitdiagnose von Alkoholismus einerseits und Schizophrenie oder affektiven Störungen andererseits weist der größte Teil der Fälle direkte kausale Beziehungen auf. Es ist sehr wahrscheinlich, daß das exzessive Vorkommen von unipolarer Depression und Alkoholismus in klinischen Stichproben auf einen erhöhten Schweregrad des Alkoholmißbrauchs hinweist, nicht aber auf eine gemeinsame Ätiologie.
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Maier, W., Linz, M., Freyberger, H.J. (1997). Komorbidität von Substanzabhängigkeitsstörungen und anderen psychischen Störungen. In: Soyka, M., Möller, HJ. (eds) Alkoholismus als psychische Störung. Bayer-ZNS-Symposium, vol 12. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-45764-7_5
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