Symptom Overlap in Mental Health Conditions

Working as a CNA in a psychiatric hospital during the summers while attending college gave me perspective into how prominent psychiatric disorders and mental illnesses are in our population. Also, I noticed that many mental illnesses have overlapping symptoms making it hard for physicians to distinguish between disorders.

In fact, around 3% of the population is suffering from more than one mental disorder at a single time (4). Also, about 20% of adults in the United States have a mental illness suggesting how prominent they are in society (4). Although I worked with very severe mental disorders I sometimes questioned if a person actually had two disorders or if they had one disorder with a prominent symptom which was mistaken as a separate disorder. After doing some research it turns out that this is in fact a common problem with mental illnesses. Not only do many mental illnesses share a common genetic basis, but as mentioned previously, they share symptoms. “Co-occurring” disorders is the term commonly used to identify these mental illnesses with overlapping symptoms (2).

One prominent example of a co-occurring disorder I had experience with when working was autism spectrum disorder (ASD). Individuals diagnosed with autism sometimes have trouble communicating which causes them to develop frustration, especially if they do not have verbal communication ability (1). This frustration is sometimes diagnosed as bi-polar disorder even though it was a symptom that arose from ASD. Further, many autistic individuals have the symptom of unusual finger movements which is sometimes diagnosed as obsessive compulsive disorder (OCD). Other common diagnoses seen with autism are ADHD, anxiety, depression, schizophrenia (1).

The issue that arises with co-occurring disorders is the treatment with medications. If someone is diagnosed with ADHD the medication used to treat that illness may cause the ADHD to improve, but the bi-polar disorder of the individual to get worse (2). If an individual actually has multiple disorders it is important there is an accurate diagnosis when considering medications for treatment as a combination of medications may be needed. Also, if a second mental disorder is diagnosed in someone with really only one mental disorder, the physician may steer away from using certain medications. Similar to the example above with ADHD, physicians may be afraid of using a certain medication as they believe it might make the second disorder worse. But, if that individual only has one disorder, not two, it would allow for better treatment of the individual as there might be more options.   

It is important that individuals are educated about co-occurring disorders. More research and diagnosing tools need to be developed to help accurately diagnose mental disorders. Having an accurate way of separating overlapping symptoms could potentially help in the treatment of these mental disorders.  

1.      Treatment for associated psychiatric conditions [Internet]. [2013]. Autism Speaks; [cited 2013 November 29]. Available from:  http://www.autismspeaks.org/what-autism/treatment/treatment-associated-psychiatric-conditions

2.      Overlap between disorders [Internet]. [2005]. Okanagan Clinical Trials-Grown Media; [cited 2013 November 29]. Available from: http://www.okanaganclinicaltrials.com/public/column.php?category=Other%20Subjects&title=Overlap+between+disorders

3.      Preidt R. Genetic Overlap Seen in Five Mental Disorders [Internet]. [Updated 2013 Aug 11].  HealthDay Reporter; [cited 2013 November 29]. Available from: http://www.webmd.com/mental-health/news/20130811/genetic-overlap-seen-in-five-mental-disorders

4.      The Science of mental illness: Information about mental illness and the brain [Internet].  National Institute of Health; [cited 2013 November 29]. Available from:   http://science.education.nih.gov/supplements/nih5/mental/guide/info-mental-a.htm