The presence of malignant ascites is a severe end-stage manifestation of the disease accompanied by several symptoms including nausea, appetite loss, abdominal tenderness and pain, fatigue and dyspnea, loss of proteins, and electrolyte disorders 15.
Both studies included in- and out-patients, which may indicate that cases were at a more severe end of the spectrum than in some other studies; however, Safer et al. (2012) did not recruit all the participants at the same time, and the cases in each group were not assessed by the same clinicians, which introduces potential sources of bias.
Additionally, a diagnosis relying on the presence or absence of a symptom has been shown to have a higher sensitivity than a diagnosis that relies on a question indicating the severe end of a normal continuum, such as excessive bleeding [ 32].
It was a far less severe end to their cases than seemed possible when the six students were initially charged with attempted murder in a 2006 attack on Justin Barker, a white student at Jena High School.
Growing evidence suggests SAD simply reflects the most severe end of a spectrum of social anxiety severity (Crome et al., 2010; Stein and Stein, 2008), and it is possible people experiencing anxiety only in public performance situations experience sub-threshold social anxiety not severe enough to meet diagnostic criteria.
These patients may represent the severe end of a wide range of phenotypes and thus individualization of treatment for each patient may be justified.
Autism comprises the severe end of a group of autism spectrum disorders (ASD), which also include Asperger syndrome, pervasive developmental disorder not otherwise specified (PDD-NOS), and rare syndromic forms including Fragile X and Rett syndromes [6].
LCA displays variable expression, and seems to represent the extreme and severe end of a spectrum of inherited retinal disease.
The finding of a higher hospital mortality rate in women than in men is supported by the observations that type I brittle asthma – a phenotype at the most severe end of the clinical spectrum – is more common in women [ 43].
In the autosomal dominant families reported with these regulatory mutations affecting SOX9, PRS represents the most severe end of a spectrum that includes cleft palate with micrognathia and isolated micrognathia.
Provided the specific DSH methods in each scale are hierarchically ordered, total scores may quantify the degree to which respondents have progressed to the more severe end of a DSH latent construct [ 15] in response to increasing levels of psychological distress or continued failed coping [ 50].
