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Objective: To explore correclational relationship between the risk factors and medical resources consumption in cardiovascular disease patients. Methods: A database containing 44940 cardiovascular disease patients in a southern Taiwan Medical center from year 2003 to 2005 was chosen as studying sample. By applying Charlson Comorbidity Index as one of the major risk factors to these cardiovascular disease patients, then using liner regression to analyze the data for their relationship with medical resources consumption. Results: Medical resources consumption increases as the cardiovascular disease patients become older. The higher the comorbidity index weight with the patient, the more the patient consumes medical resources. A patient¡¦s comorbidity index weight has great influence to the length of hospital stay of the patient and the frequency of clinic visit of the patient. The higher the comorbidity index weight a patient he or she, is likely to stay in hospital longer or to see doctors more often. The variance inflation factor (VIF) of each independent variable is ranged between 1 and 1.343, which means there are no high correlations between independent variables in the modes. In other words, there is no correlative influence effect that would invalidate the assumption. Conclusion: The findings of this study can be a good reference to hospital disease management. In addition, they can be applied to predicting the risk factor in medical resources consumption. Also they can be adapted into medical insurance payment system, thereby improving medical resource distribution.

Synaesthesia is a hereditary, neurological condition in which common stimuli trigger unexpected secondary sensations. For example, reading letters may result in the visualisation of colour, a variant known as grapheme-colour synaesthesia. While synaesthesia is thought to confer a range of benefits such as improved memory, empathy, visual search and creativity to the synaesthete, there is a small, yet growing, body of evidence that suggests synaesthesia may also be associated with more clinical conditions. This thesis investigates potential associations between synaesthesia and a range of clinical conditions, identifying a set of cormorbidities, and exploring the possible genetic roots of these associations. First, I identified an increased prevalence of multiple sclerosis (MS) and its clinical precursor, radiologically isolated syndrome (RIS) in synaesthetes self-referring for participation in scientific studies. Furthermore, I identified an increased occurrence of anxiety disorder in randomly sampled synaesthetes. In addition, I show that synaesthetes with anxiety disorder experience reduced luminance in their synaesthetic colours. I also conducted an association study into the genetic origins of synaesthesia and propose the immune hypothesis of synaesthesia, which provides a theoretical basis for comorbidities (linked to the altered cortical connectivity thought to underlie the development of synaesthesia). Finally, in phenotyping synaesthesia in individuals, I also validated the most widely used online test for synaesthesia, and use this test to provide a reliable prevalence of grapheme-colour synaesthesia in the general population. Such baselines are important for establishing whether other (e.g., clinical) populations are showing rates of synaesthesia higher than otherwise expected. I also demonstrate there is no significant difference in grapheme-colour synaesthesia prevalence between the sexes and discuss its implications for genetic theories of synaesthesia.

The associated features, high rates of comorbidity and chronicity of Posttraumatic Stress Disorder (PTSD) and Borderline Personality Disorder (BPD) raise questions regarding the distinctiveness of the two disorders. The present study expands upon previous literature by providing an investigation of clinical features across two groups: PTSD only and comorbid PTSD and BPD in a sample of male veterans (n=178). Results suggest that the two groups were distinct, with the comorbid group displaying higher levels of depression, hostility, alcohol use and general psychopathology. Groups did not differ on rates of personal trauma, adult sexual abuse, childhood sexual abuse, attack, accident or disaster. The two groups did differ significantly on rates of childhood violence.

Diabetes Care Program of Nova Scotia (DCPNS) Registry data were used to examine factors associated with survival for clinically confirmed diabetes mellitus (DM) cases. Type 1 (N=2,043) and type 2 (N=47,974) cases were followed from first Diabetes Centre visit until death/study end. Kaplan Meier curves and Cox proportional hazard models were used to explore differences in survival by sex, district health authority of care, and comorbidity status (hypertension and/or dyslipidemia). Median lifespan for type 1 cases was 12 years shorter than for type 2 cases. Hazard rate ratios for those with dyslipidemia, hypertension, or both compared to those with neither comorbidity were 1.63, 2.57, and 7.52 for type 1 cases and 0.95, 1.15, and 1.00 for type 2 cases. Disease progression and the relationship between comorbidity status and survival differed markedly for the type 1 and type 2 DM populations underscoring the need to examine these populations separately.

Thesis (Ph. D.)--Florida State University, 2004. / Advisor: Dr. Alan R. Lang, Florida State University, College of Arts and Sciences, Dept. of Psychology. Title and description from dissertation home page (viewed Sept. 24, 2004). Includes bibliographical references.

The higher occurrence of autism spectrum disorder (ASD) and sub-threshold autistic traits in males, relative to females, has been consistently documented in the literature (e.g., Fombonne 2003, 2005). In addition to potential biogenetic mechanisms, there is some evidence suggesting that differences in the behavioral manifestation of ASD symptoms and co-occurring psychopathology may play a role in the differential prevalence of ASD in males and females (e.g., Holtmann, Bolte, and Poustka, 2007; Lai et al., 2011; Solomon, Miller, Taylor, Hinshaw, and Carter, 2012). In this two-phase study, we sought to examine potential gender differences in the relationship between behaviorally defined ASD traits and observable social impairment and co-occurring psychopathology, in a non-clinical sample of young adults. It was hypothesized that gender would moderate the relationship between ASD traits and observed social impairment and co-occurring psychopathology, such that ASD traits would be related to greater levels of observed social impairment for males, and that ASD traits would be related to greater levels of co-occurring psychopathology for females. In Phase I, 1039 undergraduate students participated in an online survey on general psychopathology and ASD traits. From this sample, a subgroup (n = 79) completed Phase II, an in-lab study that included a clinical interview and behavioral observation. ASD traits were not predictive of observed social impairment over and above the effects of social anxiety in this sample, regardless of gender. Although males and females in the sample did not differ on severity of ASD traits, when controlling for the effect of social anxiety, females were rated as more socially competent than males. ASD traits more strongly predicted screening positive for mood disorders in females than in males. Implications regarding ASD traits, as related to social impairment and co-occurring psychopathology in females are discussed. / Ph. D.

Social anxiety disorder (SAD) is defined by persistent, irrational anxiety in social situations while generalized anxiety disorder (GAD) is characterized by excessive worry unrelated to any specific situation. These two disorders share some features and are frequently comorbid in children and adults. The current study sought to examine this comorbidity and compare the disorders on a number of dimensions in a clinical sample of children and adolescents. It was hypothesized that SAD would be accompanied by higher levels of social anxiety and behavioral inhibition and lower levels of family expressiveness and social functioning than GAD. GAD was hypothesized to be accompanied by higher levels of worry, physiological symptoms, and anxiety sensitivity and lower levels of school functioning as compared to SAD. Youth with both disorders were hypothesized to function more poorly on all dimensions as compared to either disorder alone. Participants were drawn from a sample of 397 (137 female) youth who underwent psychoeducational assessment. A series of analyses of variance, discriminant function analyses, and factor analyses were performed using the entire sample, and repeated by gender and age group. Results indicated youth with GAD had higher levels of harm avoidance as compared to youth with social anxiety disorder. However, the diagnostic groups did not differ on other features. Moreover, results of factor and discriminant function analyses did not distinguish between the two groups. The pattern of results was similar when examined for gender and age, although some differences emerged. Overall, results suggest SAD and GAD overlap significantly in children, with less overlap in adolescents. This raises questions regarding the validity of current child anxiety taxonomies. Future research should further examine this phenomenon, including longitudinal samples and a wider range of diagnoses. / Ph. D.

One of the most common pairs of co-occurring psychological disorders in children and adolescents is anxiety and depression. This high frequency of co-occurrence has led to research examining the structure of anxiety and depression, specifically the shared and unique aspects of these syndromes. The tripartite model accounts for the overlap between the disorders by suggesting that they are related because they share the feature of negative affect or general psychological distress. The model further proposes that they can be differentiated by their unique features of physiological hyperarousal (anxiety) and low positive affect (depression). Factor analytic research has shown that anxious symptoms and depressive symptoms can be structurally distinguished and research on the tripartite model has suggested their conceptual distinction. However, research has not shown that anxiety and depression cluster as distinct symptoms in samples of youth. The current study used cluster analysis to examine the grouping of individuals based on their levels of anxiety and depression. It was hypothesized that four groups would emerge-- anxiety only, depression only, comorbid anxiety and depression, and low/no symptoms. Further analyses using the tripartite model variables provided support of the accurate classification of individuals and this model was shown to be a useful tool in differentiating anxious symptoms from depressive symptoms. Exploratory analyses regarding developmental differences in the structure of anxiety and depression provided mixed support.

Thesis advisor: Stephanie C. Berzin / The primary aim of this study was to determine if various typologies of psychiatric diagnoses and patterns of comorbidity are differentially related to the medical lethality of adolescent suicide attempts. The secondary aim was to determine if the relationship between psychopathological comorbidity and suicide attempt lethality is significantly different across gender, age, and race in adolescents. To investigate these relationships, psychiatric evaluations were reviewed for all adolescents that presented to Children's Hospital Boston (CHB) from 2006 to 2010 for a suicide attempt (N = 375). Bivariate and OLS regression analyses were used to test hypotheses. Bivariate results showed that attempters diagnosed with a Substance Abuse Disorder comorbid with any other disorder had higher levels of suicide attempt lethality than those without the diagnosis. Additionally, having Bipolar or Mood Disorder NOS in combination with either Substance Abuse alone or Substance Abuse and Disruptive Disorders had a significant positive relationship with suicide attempt lethality when compared to other comorbidity patterns. In OLS regression, having Substance Abuse comorbid with any other disorder was the only significant diagnostic predictor of lethality. Female gender did not have a significant relationship with lethality. Age group was not predictive of lethality in regression analysis. African-American/Black race had a negative relationship with lethality in bivariate and multivariate analyses. Study findings have important implications for practice, policy, and future research with suicidal adolescents. Results suggest that improvements in the assessment and treatment of substance abuse in suicidal adolescents can play a critical role in decreasing the adolescent suicide rate. Screening for symptoms other than depression, such as substance use, will be critical to effective suicide prevention practices. Future research should focus on the development of effective treatment strategies with suicidal adolescent substance abusers, and aim for a better understanding of suicidal behaviors of adolescents with comorbid bipolar and substance abuse diagnoses. In order to further develop prevention and treatment strategies with this population, policies must be initiated that will support their advancement. / Thesis (PhD) — Boston College, 2011. / Submitted to: Boston College. Graduate School of Social Work. / Discipline: Social Work.