Features of comorbidity in narcological practice
The problem of comorbidity occupies a central position in the modern medical paradigm. This assertion requires no specific substantiation, because a large share of publications in recent decades is dedicated to various aspects of this problem. However, direct medical practice, particularly in psychiatry and addiction medicine, suggests that comorbidity, as the phenomenon of mutual reinforcement of coupled pathological conditions, characterizes merely a part of the problem. In clinical practice, we often deal with cases when two (or more) pathologic conditions coexist in such a way that manifestations of one of them weaken those of the other, i. e. the conditions are in an antagonistic relationship. These are cases where the expression of a concomitant pathology weakens manifestations of the main disease, i. e., has a favorable impact on the course of the latter. This antagonistic relationship should be considered to imply a different principle of coexistence of pathological processes - not only psychopathological, but physical as well. It is this relationship of pathological conditions that we propose to define as «countermorbidity».