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Carmelle Peisah

Publications and source records attributed to Carmelle Peisah.

5 recordsLinked to original sources
PubMed2006

Practical application of family and systems theory in old age psychiatry: three case reports.

The role of the family or carer in old age psychiatry is well acknowledged. However, carer interventions are often focused on addressing carer burden alone and are usually individually rather than family based. Interpersonal conflict and family dynamics are rarely addressed. This is not surprising as there is a paucity of literature in family and systems theory applied to the older person, and clinicians are often skeptical about the efficacy of this treatment mode or daunted by the complexity of family and systems theory. Three cases are presented to illustrate the potential benefits of family-based interventions in the setting of commonly encountered clinical situations: (i) the treatment of chronically depressed older people in the community; (ii) the management of behavioral and psychological symptoms of dementia (BPSD) in residential care; and (iii) home-based support and care of the older patient with dementia.

Aged↗
PubMed2006

Family conflict in dementia: prodigal sons and black sheep.

OBJECTIVE: To describe family conflict in cases of dementia referred to the Guardianship Tribunal of New South Wales, Australia. METHOD: The file notes of 50 cases of family and systems conflict in cases of dementia presented to the Guardianship Tribunal were examined. Demographics, MMSE score, and type and severity of dementia were recorded. The documents and evidence presented to the Tribunal were coded and subjected to thematic analysis to identify the themes of the conflict, the protagonists and the position of the person with dementia with respect to the conflict. RESULTS: Family conflict was most commonly seen in mild to moderate dementia. Conflict occurred most frequently between siblings (with a group of siblings allied against a 'black sheep' member) and involved other systems such as service providers in 25% of cases. The person with dementia was usually involved in the conflict or in alliance with one or other of the family members in conflict, especially when paranoid ideation was fuelled by family members. Common themes included accusations of neglect, exploitation, lack of communication or sequestration of the person with dementia. No family had received family therapy prior to the application; conciliation during the hearing was successful in 30% of cases. Legal transactions such as Powers of Attorney were frequently made and frequently revoked by persons with dementia involved in family conflict. CONCLUSION: Dementia may be a great family divider, particularly when there are cracks in family solidarity. The understanding of family conflict in dementia has ramifications for both clinical and medico-legal practice. These findings may encourage family-centered interventions which address family dynamics and interpersonal conflict. They may also assist in capacity assessments of persons with dementia who change legal documents because of family conflict.

Aged↗
PubMed2005

Children of a cohort of depressed patients 25 years on: identifying those at risk.

OBJECTIVE: Factors associated with psychological outcome in children of patients with depression have been examined piecemeal, with emphasis on young rather than adult children. We hypothesized that psychological morbidity in adult children of patients with depression would be associated with characteristics of the children, their parents and their family relationships. METHOD: Factors predicting psychopathology in children (n = 94) of a cohort of patients with depression, admitted to a teaching hospital 25 years earlier, were examined using logistic regression. RESULTS: Psychological morbidity in children was predicted by their being younger at parent's admission, their perception of the depressed parent as more controlling and chronicity of the parent's depression. Correlations between child characteristics, parent illness and family relationship variables showed systemic interactions between parental illness, child psychopathology and family relationships. CONCLUSION: Chronicity (though neither recurrence nor severity) of parent depression and younger children's age at the time of parental admission for depression were associated with psychological morbidity in the children in adulthood. The interaction between child psychopathology, parental illness and family relationships emphasizes the need for a systemic, family focus in the treatment of depression.

Adolescent↗