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Biomedical subjects

C Peisah

Publications and source records attributed to C Peisah.

8 recordsLinked to original sources
PubMed2006

Investigation of Alzheimer's disease-related pathology in community dwelling older subjects who committed suicide.

BACKGROUND: Older people have a higher risk of completed suicide than any other age group worldwide. The contribution of neurodegenerative disease to this risk remains controversial. AIMS: To investigate prevalence of Alzheimer's disease-related (AD) pathology in older suicide victims. METHODS: Ratings of AD pathology using Braak and CERAD protocols were compared in 143 community-dwelling suicide victims aged 65 years or more and 59 motor vehicle accident victims autopsied at the request of an Australian Coroner's Court. RESULTS: There were no significant differences in plaque score or neurofibrillary tangle staging between suicide and control groups. None of the subjects with a history of dementia had neuropathologically confirmed AD. CONCLUSIONS: Our study is the second and largest investigation of the prevalence of AD neuropathology in the elderly suicide population. Unlike the previous study, we did not find an increased prevalence of AD neuropathology despite a history of dementia in 6.3%, implicating other pathologies such as Lewy Body or Vascular dementia in the aetiology of dementia in elderly suicide victims.

Accidents, Traffic↗
PubMed2004

Children of a cohort of depressed patients 25 years later: psychopathology and relationships.

BACKGROUND: While many studies have examined cross-sectional or short-term effects of parental depression on children, few have studied such children many years later when they reach adulthood. It was hypothesised that children of patients hospitalised for depression 25 years ago would have more psychological morbidity and relationship difficulties than children of a surgical comparison group. METHOD: Children (n=94) of depressed patients and a surgical control group (n=31) admitted to a teaching hospital 25 years ago were compared on measures of psychiatric morbidity, personality, marital and family relationships. RESULTS: Compared with control children, children of depressed patients demonstrated trends for higher rates of non-phobic anxiety and substance disorders, but neither psychological morbidity overall nor affective disorder specifically. Compared with control children, children of depressed patients rated their relationships with fathers who were spouses of female patients more negatively. Having consciously tried to make their own intimate relationships different from that of their parents, children of depressed patients and their partners reported significantly more caring in their relationships compared with control children and their partners. CONCLUSION: In this study of the effects of parental depression on children 25 years on, adult children of depressed patients demonstrated significant resilience as evidenced by similar rates of overall psychiatric morbidity and quality of intimate relationships to controls. They may be at risk for specific disorders such as anxiety and substance disorder and have problematic relationships with the "well" spouses of depressed patients particularly if the "well" spouse is their father.

Adult↗
PubMed2003

Neuropsychological performance and dementia in depressed patients after 25-year follow-up: a controlled study.

BACKGROUND: Previous research has yielded conflicting evidence regarding the long-term cognitive outcome of depression. Some studies have found evidence for a higher incidence of subsequent cognitive impairment or dementia, while others have refuted this. METHOD: Depression, neuropsychological performance, functional ability and clinical variables were assessed in a sample of patients who had been hospitalized for depression 25 years previously. RESULTS: Data were available on 71 depressed patients (10 of whom were deceased) and 50 surgical controls. No significant differences were found between depressed subjects and controls on any neuropsychological measure. Ten depressed patients but no controls were found to have dementia at follow-up (continuity corrected chi2 = 5.93, P < 0.01). Presence of dementia was predicted by older age at baseline. Vascular dementia was the most common type. CONCLUSIONS: We conclude that this study did not find evidence that early onset depression is a risk factor for Alzheimer's disease, but that for a small subgroup there appears to be a link with vascular dementia. Several plausible explanations for this link, such as lifestyle factors, require further investigation.

Age Factors↗
PubMed2001

A 25-year longitudinal, comparison study of the outcome of depression.

BACKGROUND: There is still a relative paucity of information about the long-term course of depression. METHODS: Consecutive patients admitted to a teaching hospital psychiatry unit with symptoms of depression, previously assessed at 6 months and 2, 5 and 15 years after index admission, were reviewed at 25 years (N = 49, including eight informants of deceased probands, of an original 145 with major depression (DEPs)). Prospective psychiatric (N = 22) and retrospective surgical (N = 50) control groups assessed after 25 years were used for comparison. RESULTS: A further decade of follow-up confirmed the chronicity of depression. Of depressed patients (DEPs) followed for the full 25-year-period only 12% of the 49 original DEPs recovered and remained continuously well, 84% experienced recurrences, 2% experienced an unremitting course and another 2% died by suicide. Note that in the first 15-year-period 6% (9/145 DEPs) committed suicide, a further 38 died and 32 were lost to follow-up. They experienced an average of three episodes of depression over the 25 years. In the decade since the 15-year follow-up, 27% improved in clinical outcome (including four of five previously chronically depressed patients), 55% remained unchanged and 18% worsened; and the number of episodes per year declined. Patients initially diagnosed with neurotic or endogenous depression had similar long-term outcomes. The criteria for a current DSM-III-R disorder were met by 37% of DEPs, including 11% with depression or dysthymia. On the global assessment of functioning scale 78% of the DEPs had some impairment compared to 62% of psychiatric controls and 40% of surgical controls. CONCLUSION: Even after 25 years, severe depressive disorders appear to have poor long-term outcomes. Patients with chronic outcomes over 15 years can improve when followed over longer periods.

Antipsychotic Agents↗
PubMed1994

Practical guidelines for the treatment of behavioural complications of dementia.

A step-by-step approach to management of behavioural problems in dementia is outlined. Initial strategies include assessment of the underlying cause and consideration of non-pharmacological methods of treatment. If pharmacotherapy is required, the altered pharmacokinetics in the elderly and the variable efficacy of different psychotropic drugs should be kept in mind. Recommendations regarding drug dosage, monitoring and review are given.

Aged↗
PubMed1991

Caring for the institutionalised elderly: how easy is it?

In the light of long-standing criticism of nursing homes an assessment of staff's ability to provide care was required. By creating a profile of nursing home staff it may be possible to explain and predict difficulties in providing care. One hundred and five staff from 15 nursing homes and 18 hostel staff were interviewed to examine demographic characteristics, attitudes to the job and to the elderly, as well as sources of stress in the workplace. Staff were predominantly female, with children, and had a strong sense of altruism and desire to nurture. They foster an atmosphere of care and protection and may unwittingly encourage dependence. This may preclude challenge and rehabilitation for nursing home residents. Constraints such as staff shortages, stress (35.3 per cent cases on the General Health Questionnaire), lack of training, conflict among staff and lack of support may hamper care. These problems could be addressed by additional training and incentives for staff, increased staff cooperation and communication. Medical practitioners and other health professionals have a significant role to play in assuming greater responsibility for supporting the caregivers in nursing homes.

Attitude of Health Personnel↗