A cluster analysis-derived classification of psychological distress and illness behavior in the medically ill

2011 ◽  
Vol 42 (2) ◽  
pp. 401-407 ◽  
Author(s):  
G. A. Fava ◽  
J. Guidi ◽  
P. Porcelli ◽  
C. Rafanelli ◽  
A. Bellomo ◽  
...  
Keyword(s):  
Cluster Analysis ◽  
Psychological Distress ◽  
Type A Behavior ◽  
Illness Behavior ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Medically Ill ◽  
Abnormal Illness Behavior ◽  
Dsm Iv

BackgroundThe classification of psychological distress and illness behavior in the setting of medical disease is still controversial. Current psychiatric nosology does not seem to cover the spectrum of disturbances. The aim of this investigation was to assess whether the joint use of DSM-IV categories and the Diagnostic Criteria for Psychosomatic Research (DCPR), that provide identification of syndromes related to somatization, abnormal illness behavior, irritable mood, type A behavior, demoralization and alexithymia, could yield subtyping of psychosocial variables in the medically ill.MethodA cross-sectional assessment using both DSM-IV and the DCPR was conducted in eight medical centers in the Italian Health System. Data were submitted to cluster analysis. Participants were consecutive medical out-patients and in-patients for whom a psychiatric consultation was requested. A total of 1700 subjects met eligibility criteria and 1560 agreed to participate.ResultsThree clusters were identified: non-specific psychological distress, irritability and affective disturbances with somatization.ConclusionsTwo-step cluster analysis revealed clusters that were found to occur across clinical settings. The findings indicate the need of expanding clinical assessment in the medically ill to include the various manifestations of somatization, illness behavior and subclinical distress encompassed by the DCPR.

The clinical inadequacy of the DSM-5 classification of somatic symptom and related disorders: an alternative trans-diagnostic model

CNS Spectrums ◽  
2015 ◽  
Vol 21 (4) ◽  
pp. 310-317 ◽  
Author(s):  
Fiammetta Cosci ◽  
Giovanni A. Fava
Keyword(s):  
Clinical Utility ◽  
Somatic Symptom ◽  
Illness Behavior ◽  
Diagnostic Model ◽  
Review Of The Literature ◽  
Clinical Issue ◽  
Abnormal Illness Behavior ◽  
Psychosomatic Research ◽  
Dsm 5

The Diagnostic and Statistical of Mental Disorders, Fifth Edition (DSM-5) somatic symptom and related disorders chapter has a limited clinical utility. In addition to the problems that the single diagnostic rubrics and the deletion of the diagnosis of hypochondriasis entail, there are 2 major ambiguities: (1) the use of the term “somatic symptoms” reflects an ill-defined concept of somatization and (2) abnormal illness behavior is included in all diagnostic rubrics, but it is never conceptually defined. In the present review of the literature, we will attempt to approach the clinical issue from a different angle, by introducing the trans-diagnostic viewpoint of illness behavior and propose an alternative clinimetric classification system, based on the Diagnostic Criteria for Psychosomatic Research.

The Location Types of US Retailers

2016 ◽  
Vol 7 (4) ◽  
pp. 1-22 ◽  
Author(s):  
Lawrence Joseph ◽  
Michael Kuby
Keyword(s):  
Cluster Analysis ◽  
Cross Sectional ◽  
Trade Area ◽  
Urban Markets ◽  
Retail Business ◽  
Retail Location ◽  
Retail Chains ◽  
Location Profile ◽  
Similar Location

This manuscript presents the results of an inductive analysis of the types of locations chosen by US retailers. Using a large cross-sectional database, including fifty US retail chains and over 70,000 store locations, a classification of retail location types is presented using cluster analysis on situational and trade area data. These data are then applied to create a location profile for each retailer. Based on the results of the first cluster analysis, a second cluster analysis then groups together the chains with the most similar location profiles. A total of twelve distinct location types were identified in the first cluster analysis. Eight groupings of retailers with similar location profiles were identified in the second cluster analysis. Retailers within the same retail business chose similar types of locations and thus were placed in the same clusters. Retailers generally restrict their deployment to one of three overall strategies including metropolitan, large retail areas, or market size variety with specialty retailers favoring large retail areas of urban markets.

scholarly journals Multimorbidity, psychoactive substance use and psychological distress among acute medically ill patients: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e052428
Author(s):  
Saranda Kabashi ◽  
Danil Gamboa ◽  
Vigdis Vindenes ◽  
Thomas Berg ◽  
Thor Arthur Hilberg ◽  
...  
Keyword(s):  
Substance Use ◽  
Psychological Distress ◽  
Alcohol Use ◽  
Illicit Drugs ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Medically Ill ◽  
Risky Alcohol ◽  
Medicinal Drugs ◽  
Medically Ill Patients

BackgroundIn order to target the complex health needs of patients with multimorbidity using psychoactive substances, knowledge regarding the association between substance use and multimorbidity in an acute setting is needed.AimsExamine psychoactive substance use patterns among acute medically ill patients, and determine the association between multimorbidity and substance use, and psychological distress.DesignCross-sectional study.Setting and participants2874 acute medically ill patients admitted to a medical emergency department in Oslo, Norway.MeasurementsPrimary outcome: multimorbidity recorded by the presence of ≥2 International Classification of Diseases 10th revision—physical and/or mental health conditions per patient, extracted from medical records. Predictor variables: self-reported data on age, sex, occupational status, psychological distress (Hopkins Symptom Check List-5), alcohol use (Alcohol Use Disorder Identification Test-4) and results from blood samples on psychoactive medicinal and illicit drugs.FindingsOf all patients, 57.2% had multimorbidity. Of these, 62.6% reported psychological distress, 85.5% consumed either alcohol, medicinal and/or illicit drugs and 64.4% combined alcohol with psychoactive medicinal drugs. Patients with risky alcohol use were more likely to have multimorbidity compared with patients with low-risk alcohol use (OR 1.53; 95% CI 1.05 to 2.24). Patients using psychoactive medicinal drugs were more likely to have multimorbidity compared with non-users (OR 1.34; 95% CI 1.07 to 1.67).ConclusionMultimorbidity was associated with psychoactive medicinal drug and risky alcohol use, and psychological distress. Substance use was widespread, with alcohol and psychoactive medicinal drugs most frequently combined. Monitoring substance use among multimorbid patients is necessary to develop tailored treatments, and reduce burden on the healthcare system.

Identification of sub-groups in acutely ill elderly patients with delirium: a cluster analysis

2016 ◽  
Vol 28 (8) ◽  
pp. 1283-1292 ◽  
Author(s):  
Luísa Lagarto ◽  
Joaquim Cerejeira
Keyword(s):  
Risk Factors ◽  
Cluster Analysis ◽  
Elderly Patients ◽  
Clinical Care ◽  
Cross Sectional Study ◽  
Metabolic Disturbances ◽  
Dynamic Interactions ◽  
Cross Sectional ◽  
Medically Ill ◽  
Medical Wards

ABSTRACTBackground:Delirium is a serious neuropsychiatric syndrome affecting mainly elderly participants with acute medical diseases. The pathophysiology of delirium remains poorly understood as it involves complex dynamic interactions between a diversity of risk factors. Exploring how etiological factors interact with each other can clarify the pathophysiological mechanisms and facilitate the early identification of this syndrome. The aim of this study was to explore how different risk factors co-occur in medically ill elderly patients with delirium with cluster analysis and identify clinically meaningful sub-groups in this population.Methods:A cross-sectional study was developed. Ninety-nine elderly inpatients admitted to acute medical wards diagnosed with delirium during hospitalization were selected. For each patient sociodemographic characteristics, acute and chronic medical conditions, laboratory parameters, and current medication were collected.Results:The cluster analysis extracted three distinct subgroups of participants with delirium. Patients in cluster 1 (n = 28) had higher rates of medication with anticholinergic proprieties. Cluster 2 (n = 29) included participants with cardiac and pulmonary comorbidities associated with both chronic and acute reduction of blood flow and/or oxygenation to the brain. Cluster 3 (n = 42 patients) comprised patients with simultaneous deregulation of different organs/systems, such as electrolytic disturbances, metabolic disturbances, and acute renal failure. Known predisposing factors of delirium, such as age and pre-existing dementia, were similar between groups.Conclusions:The results reveal different patterns of clinical characteristics in elderly patients with delirium. This is relevant to clinical care of acute medically ill patients and suggests that different pathways are implicated in delirium pathophysiology.

scholarly journals POS0308 TRAJECTORIES OF FATIGUE IN EARLY RA OVER 10 YEARS: RESULTS FROM THE ESPOIR COHORT

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 380.1-380
Author(s):  
S. Rodriguez-Muguruza ◽  
B. Combe ◽  
F. Guillemin ◽  
A. Olive ◽  
O. Valero ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cluster Analysis ◽  
Psychological Distress ◽  
Disease Activity ◽  
Disease Duration ◽  
Sleep Problems ◽  
Multinomial Logistic Regression ◽  
Cross Sectional ◽  
Early Ra ◽  
Patient Reported

Background:Fatigue is one of the most prevalent symptom reported by persons with RA. RA-related fatigue is a complex concept with biological, psychological and social interactions.Objectives:In a cohort of early RA patients, to determine and characterize fatigue trajectories over 10 years of follow-up and identify predictors of trajectory membership.Methods:Patients fulfilling the 2010 ACR/EULAR criteria for RA included in the ESPOIR cohort. We used a cluster analysis to obtain fatigue (assessed by fatigue visual analogue scale) trajectories over the course of 10 years from enrolment. Chi-square tests or ANOVA were performed to evaluate differences of baseline variables between fatigue trajectories. Using a multinomial logistic regression we could identify predictors of trajectory membership.Results:We analysed 598 patients with mean disease duration at enrolment of 26.2 ± 40.9 days. Cluster analysis revealed 3 trajectories: high (18%), moderate (52%) and low fatigue (30%). Compared to patients with moderate or low fatigue trajectory, patients with high fatigue trajectory were predominantly women and reported significantly higher duration and intensity of morning stiffness, HAQ score, number of tender joints, levels of pain, number of awakenings due to arthritis, levels of physician and patient global assessment and more frequent sleep problems, and increased psychological distress. Female patients with pain, psychological distress and presence of sicca symptoms had higher risk of being in high trajectory group.Conclusion:These findings suggest that levels of fatigue are rather stable over time in each trajectory. Baseline clinical measures and baseline patient-reported measures of functional status better distinguished the three fatigue trajectories. We did not find differences between trajectories in baseline laboratory measures. Inflammatory activity was not a predictor of being in high trajectory fatigue group.References:[1]Pollard LC, Choy EH, Gonzalez J, Khoshaba B, Scott DL. Fatigue in rheumatoid arthritis reflects pain, not disease activity. Rheumatology (Oxford) 2006;45:885–9[2]Repping-Wuts H, van Riel P, van Achterberg T. Fatigue in patients with rheumatoid arthritis: what is known and what is needed. Rheumatology (Oxford) 2009;48:207–9.[3]Pilgaard T, hagelund L, Stallknecht SE, jensen HH, Esbensen BA. Severity of fatigue in people with rheumatoid arthritis, psoritic artrhitis and spondyoarthritis- Results of cross-sectional study. Plos One. 2019;14:e0211831[4]Feldthusen C, Grimby-Ekman A, Forsblad-d’Elia H, Jacobsson L, Mannerkorpi K. Explanatory factors and predictors of fatigue in persons with rheumatoid arthritis: a longitudinal study. J Rehabil Med 2016 28;48:469–76.[5]Madsen SG, Danneskiold-Samsøe B, Stockmarr A, Bartels EM. Correlations between fatigue and disease duration, disease activity, and pain in patients with rheumatoid arthritis: a systematic review. Scand J Rheumatol. 2016;45:255-61.[6]Olsen CL, Lie E, Kvien TK, Zangi HA. Predictors of fatigue in rheumatoid arthritis patients in remission or in a low disease activity state. Arthritis Care Res (Hoboken) 2016;68:1043–8.[7]Druce K, Jones GT, Macfarlane GJ, Verstappen SMM, Basu N. The longitudinal course of fatigue in rheumatoid arthritis: results from the Norfolk Arthritis Register. J Rheumatol 2015;42:2059–65.Disclosure of Interests:None declared

Quick Reference: Chapter 1: The Musculoskeletal System: The Hand and Upper Extremity

2000 ◽  
Vol 5 (5) ◽  
pp. 4-5
Keyword(s):  
Dorsal Column ◽  
Persistent Pain ◽  
Illness Behavior ◽  
Abnormal Illness Behavior ◽  
Organ Systems ◽  
Spinal Cord Dorsal ◽  
Objective Basis ◽  
Dorsal Column Stimulation ◽  
Underlying Pathology

Abstract Spinal cord (dorsal column) stimulation (SCS) and intraspinal opioids (ISO) are treatments for patients in whom abnormal illness behavior is absent but who have an objective basis for severe, persistent pain that has not been adequately relieved by other interventions. Usually, physicians prescribe these treatments in cancer pain or noncancer-related neuropathic pain settings. A survey of academic centers showed that 87% of responding centers use SCS and 84% use ISO. These treatments are performed frequently in nonacademic settings, so evaluators likely will encounter patients who were treated with SCS and ISO. Does SCS or ISO change the impairment associated with the underlying conditions for which these treatments are performed? Although the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) does not specifically address this question, the answer follows directly from the principles on which the AMA Guides impairment rating methodology is based. Specifically, “the impairment percents shown in the chapters that consider the various organ systems make allowance for the pain that may accompany the impairing condition.” Thus, impairment is neither increased due to persistent pain nor is it decreased in the absence of pain. In summary, in the absence of complications, the evaluator should rate the underlying pathology or injury without making an adjustment in the impairment for SCS or ISO.

Adolescent Suicidality as Seen in Rural Northeastern Uganda

Crisis ◽  
2011 ◽  
Vol 32 (1) ◽  
pp. 43-51 ◽  
Author(s):  
Eugene Kinyanda ◽  
Ruth Kizza ◽  
Jonathan Levin ◽  
Sheila Ndyanabangi ◽  
Catherine Abbo
Keyword(s):  
Low Socioeconomic Status ◽  
Sub Saharan Africa ◽  
Psychosocial Risk ◽  
Psychiatric Nurses ◽  
Health Concern ◽  
Cross Sectional ◽  
Childhood Experiences ◽  
Low Socioeconomic ◽  
Dsm Iv ◽  
Sub Saharan

Background: Suicidal behavior in adolescence is a public health concern and has serious consequences for adolescents and their families. There is, however, a paucity of data on this subject from sub-Saharan Africa, hence the need for this study. Aims: A cross-sectional multistage survey to investigate adolescent suicidality among other things was undertaken in rural northeastern Uganda. Methods: A structured protocol administered by trained psychiatric nurses collected information on sociodemographics, mental disorders (DSM-IV criteria), and psychological and psychosocial risk factors for children aged 3–19 years (N = 1492). For the purposes of this paper, an analysis of a subsample of adolescents (aged 10–19 years; n = 897) was undertaken. Results: Lifetime suicidality in this study was 6.1% (95% CI, 4.6%–7.9%). Conclusions: Factors significantly associated with suicidality included mental disorder, the ecological factor district of residence, factors suggestive of low socioeconomic status, and disadvantaged childhood experiences.

Neurophysiologic classification of Wilson's disease by using cluster analysis

2006 ◽  
Vol 37 (01) ◽  
Author(s):  
W Hermann ◽  
T Villmann ◽  
HJ Kühn ◽  
P Baum ◽  
G Reichel ◽  
...  
Keyword(s):  
Cluster Analysis ◽  
Wilson’S Disease ◽  
Wilson's Disease

Classification of Observations through Combination of the Dimension Reduction and the Cluster Analysis

2017 ◽  
Vol 7 (8) ◽  
pp. 30
Author(s):  
Hyeuk Kim
Keyword(s):  
Machine Learning ◽  
Principal Component Analysis ◽  
Cluster Analysis ◽  
Unsupervised Learning ◽  
Principal Component ◽  
Component Analysis ◽  
Baseball Players ◽  
Partitioning Around Medoids ◽  
Different Characteristics

Unsupervised learning in machine learning divides data into several groups. The observations in the same group have similar characteristics and the observations in the different groups have the different characteristics. In the paper, we classify data by partitioning around medoids which have some advantages over the k-means clustering. We apply it to baseball players in Korea Baseball League. We also apply the principal component analysis to data and draw the graph using two components for axis. We interpret the meaning of the clustering graphically through the procedure. The combination of the partitioning around medoids and the principal component analysis can be used to any other data and the approach makes us to figure out the characteristics easily.

STUDY OF HISTOPATHOLOGY IN PATIENTS WITH HODGKIN AND NON - HODGKIN LYMPHOMA

2016 ◽  
pp. 59-65 ◽  
Author(s):  
Van Mao Nguyen
Keyword(s):  
Lymph Node ◽  
Hodgkin Lymphoma ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Cross Sectional ◽  
Histopathological Classification ◽  
Non Hodgkin Lymphoma ◽  
Key Words Lymphoma ◽  
Malignant Grade

Background: Lymphoma is one of the most ten common cancers in the world as well as in Vietnam which has been ever increasing. It was divided into 2 main groups Hodgkin and non – Hodgkin lymphoma in which non-Hodgkin lymphoma appeared more frequency, worse prognosis and different therapy. Objectives: - To describe some common characteristics in patients with non – Hodgkin lymphoma; - To determine the proportion between Hodgkin and non- Hodgkin lymphoma, histopathological classification of classical Hodgkin by modified Rye 1966 and non-Hodgkin lymphoma by Working Formulation (WF) of US national oncology institute 1982. Materials and Method: This cross-sectional study was conducted on 65 patients with Hodgkin and non- Hodgkin lymphoma diagnosed definitely by histopathology at Hue Central Hospital and Hue University Hospital. Results:. The ratio of male/female for the non-Hodgkin lymphoma was 1.14/1, the most frequent range of age was 51-60 accounting for 35%, not common under 40 years. Non - Hodgkin lymphoma appeared at lymph node was the most common (51.7%), at the extranodal site was rather high 48.3%. The non - Hodgkin lymphoma proportion was predominant 92.3% comparing to the Hodgkin lymphoma only 7.7%; The most WF type was WF7 (53.3%), following the WF6 18,3% and WF5 11,7%; The intermediate malignancy grade of non- Hodgkin lymphoma was the highest proportion accouting for 85%, then the low and the high one 8.3% and 6.7% respectively. Conclusion: The histopathological classification and the malignant grade of lymphoma for Hodgkin and non - Hodgkin lymphoma played a practical role for the prognosis and the treatment orientation, also a fundamental one for the modern classification of non - Hodgkin lymphoma nowadays. Key words: lymphoma, Hodgkin lymphoma, non-Hodgkin lymphoma, classication, grade, histopathology, lymph node

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