31. Both comorbid substance use and comorbid mental disorders increase the risk of suicide in people with problem gambling. 32. Both comorbid substance use and comorbid mental disorders increase the risk of suicide in people with problem gambling. 33. Because comorbid conditions are common with sensory integration issues, a person may have other conditions as well. 34. CASS4 has been reported to play a modifying role in cystic fibrosis severity, progression and comorbid conditions. 35. Several of these gene candidates are shared with attention-deficit hyperactivity disorder, which ASPD is comorbid with. 36. Reinforcement has also been shown to improve the self-concept in children with depression comorbid with learning difficulties. 37. Secondary insomnia, or comorbid insomnia, occurs concurrently with other medical, neurological, psychological and psychiatric conditions. 38. Several disorders, especially at the more severe ends of the spectrum tend to be comorbid with each other. 39. An initial approach often involves screening for and, if necessary, treating any mineral deficiencies or other comorbid conditions. 40. However, comorbid migraine worsens some of the additional visual symptoms and tinnitus seen in " visual snow " syndrome.