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Biomedical subjects

Anthony Pelosi

Publications and source records attributed to Anthony Pelosi.

4 recordsLinked to original sources

Adolescent-onset psychosis: prevalence, needs and service provision.

BACKGROUND: Little is known of the epidemiology and care needs of people with adolescent-onset psychosis. AIMS: To examine prevalence and the cross-sectional disability, needs and service provision for adolescent-onset psychosis in areas of central Scotland with a total population of 1.75 million. METHOD: We identified and contacted 103 young people using an opt-out research design. Fifty-three participants and their carers and keyworkers were interviewed using a modified version of the Cardinal Needs Schedule. RESULTS: The 3-year prevalence was 5.9 per 100,000 general population. Twenty-one (20%) adolescents were not in contact with mental health services; 80% of first admissions were to adult acute psychiatric wards. Those interviewed had high levels of morbidity: 29 (55%) had serious to pervasive impairment of functioning; there were relatively high levels of side-effects, negative symptoms, anxiety, occupational, friendship and family difficulties. Care provision was better for'clinical'than for'social'domains; 20% had five or more unmet needs; 17% had at least one intractable problem. CONCLUSIONS: This low-prevalence disorder requires an assertive multi-agency approach in the context of a national planning framework.

Adolescent↗

Late onset psychogenic nonepileptic attacks.

OBJECTIVE: To investigate differences between groups of patients with early vs late onset psychogenic nonepileptic attacks (PNEA). METHODS: The authors compared patients with onset of PNEA after age 55 years (n = 26) to patients whose onset of PNEA was before age 55 years (n = 241). The authors examined sociodemographic variables, factors potentially predisposing to PNEA, clinical semiology, and medical and psychiatric background. RESULTS: Patients with late onset PNEA were more likely to be male (p = 0.029) (p values are quoted uncorrected for multiple comparisons). They were less likely to report antecedent sexual abuse (p = 0.008), and more likely to have severe physical health problems (p < 0.001) and to report health-related traumatic experiences (p < 0.0001). There were no clear differences in PNEA clinical semiology. There was a trend to better baseline mental health in the late onset group. CONCLUSIONS: The data suggest a distinct subgroup of patients with late onset psychogenic nonepileptic attacks, in whom psychological trauma related to poor physical health plays a prominent role.

Age Distribution↗

Mortality after discharge from long-term psychiatric care in Scotland, 1977-94: a retrospective cohort study.

BACKGROUND: Recent United Kingdom strategies focus on preventable suicide deaths in former psychiatric in-patients, but natural causes of death, accidents and homicide may also be important. This study was intended to find the relative importance of natural and unnatural causes of death in people discharged from long-term psychiatric care in Scotland in 1977-1994. METHODS: People discharged alive from psychiatric hospitals in Scotland in 1977-94 after a stay of one year or longer were identified using routine hospital records. Computer record linkage was used to link hospital discharges to subsequent death records. Mortality was described using a person-years analysis, and compared to the general population rates. RESULTS: 6,776 people were discharged in the time period. 1,994 people (29%) died by the end of follow-up, 732 more deaths than expected. Deaths from suicide, homicide, accident and undetermined cause were increased, but accounted for only 197 of the excess deaths. Deaths from respiratory disease were four times higher than expected, and deaths from other causes, including cardiovascular disease, were also elevated. CONCLUSION: Suicide is an important cause of preventable mortality, but natural causes account for more excess deaths. Prevention activities should not focus only on unnatural causes of death.

Cardiovascular Diseases↗