What if the 70% comorbidity rate in psychiatry is a myth? Discover a diagnostic hierarchy that could cut down pills and labels.

In this live‑stream episode, host Nasiragami is joined by psychiatry resident Daniel Herringer to dissect why the term “comorbidity” in mental health is often a misnomer. They trace its origins to the 1960s, show how DSM‑III turned overlapping symptom sets into artificial disorders, and argue that nature rarely hands out multiple independent illnesses at once.

The conversation pivots to a diagnostic hierarchy: start with the illness that explains the most symptoms (often a mood disorder) and rule out narrower labels only after the primary condition is treated. Real‑world examples—borderline personality disappearing after depression resolves, bipolar‑OCD fading when mood episodes end, and a patient’s “ADD” vanishing after stopping an antidepressant—illustrate how fewer diagnoses can mean fewer medications and better outcomes.

For deeper reading see:
The original 1979 hierarchy paper
https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/abs/hierarchy-model-of-psychiatric-symptomatology-an-investigation-based-on-present-state-examination-ratings/61EDD658A63262C07579671481D3B4F9,
Van Praag’s critique
https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/abs/comorbidity-psycho-analysed/F1AFDC245EF1CBB4790D6400BADC6389,
The nosologomania article
https://www.tandfonline.com/doi/abs/10.3109/15622970009150584,

The borderline PD outcome study https://pmc.ncbi.nlm.nih.gov/articles/PMC3289285/,

The bipolar‑OCD review https://onlinelibrary.wiley.com/doi/full/10.1111/acps.12250.

If you’re ready to rethink psychiatric labeling and simplify treatment, hit follow and stay tuned for more deep dives.