Abstract
Having been trained to follow the edict of Ockham that ‘It is vain to do with more, what can be done with fewer’, for too long I clung to the belief that anxiety was a symptom of depression and that it was almost diseasemongering to consider a double diagnosis of major depressive disorder and an anxiety disorder. I now see the error of my ways and have learnt the value of identifying and treating the comorbid conditions. We now know similar issues arise in the management of drug and alcohol dependence. More recently, I have found that a similar approach to patients with psychosis is resulting in much greater symptom relief, and a better quality of life. Given the problems of applying DSM-IV to clinical practice I am writing to suggest that when assessing our patients, rather than being surprised by the frequency of comorbitity, we should assume that all our patients are comorbid until proven otherwise.