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Biomedical subjects

Isabelle Jalenques

Publications and source records attributed to Isabelle Jalenques.

3 recordsLinked to original sources

Elderly suicide attempters: characteristics and outcome.

PURPOSE: We made a descriptive survey to assess the outcome of elderly patients discharged from a hospital psychiatric service after a suicide attempt (rates of overall mortality and repeat attempts), to identify the factors that had a significant impact on their survival and to determine patient characteristics. METHODS: Fifty-nine suicide attempters over 60 years of age admitted to hospital between 1993 and 2000 were included in the study. Their outcome was assessed by questioning their attending physicians over the telephone. We traced 51 of the 59 patients; 8 were lost to follow-up. Statistical analysis (Log Rank tests, Cox model) was computed to determine which factors altered the overall survival and the survival without further attempt. The patients sociodemographic, medical and psychiatric characteristics were recorded from hospital patient files. RESULTS: Elderly suicide attempters showed an increased mortality from suicide and natural causes and the risk of a repeat attempt increased in female patients with memory disorders. The factors altering survival were advanced age, pre-existing physical disability, several co-existing physical illnesses, severe physical consequences of the suicide attempt, history of psychiatric illness other than depression, memory disorders and one previous suicide attempt. The elderly suicide attempter was most likely to be a widowed woman suffering from social isolation, loneliness and depression. CONCLUSION: Elderly suicide attempters remained both physically and mentally vulnerable after their attempt. A repeat act represents a turning point in personal life progression which it is essential to detect.

Age Factors↗

[Bipolar disorders in the elderly].

Usual diagnostic criteria are not suited with the diagnosis of bipolar disorders in the elderly, which then remain often undetected. Bipolar disorders in the elderly are clinically heterogeneous and present with various courses: switch from recurrent depression to mania, early onset or late bipolar disorders. In the elderly, bipolar disorders can take uncommon aspects such as depressive or mixed symptoms, psychosis, mental confusion or dementia. Results from the literature devoted to the evolution of bipolar disorders during life or in terms of age at onset are often contradictory. The prognosis of bipolar disorders in the elderly is poor due to higher prevalence of recurrences, associated somatic disorders, reduced survival and severe handicap. There is an immediate need for collaboration between patients, families, clinicians, researchers, governmental agencies, and third-party payers to improve the diagnosis, treatment, and delivery of services for elderly subjects with bipolar disorders.

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[Measurement of the prevention policy in the hospital].

INTRODUCTION: Prevention policy is a legal obligation for French hospitals. As such, preventive clinical practices should therefore be assessed. OBJECTIVE: Assess the results of the hospital prevention policy. METHOD: A cross-sectional, stratified epidemiological survey, took place in 10 hospital wards of the university hospital of Clermont-Ferrand. The patients included had to be aged over 60 and leaving the hospital. The criteria for prevention assessment were surveillance of blood pressure and glycaemia, screening of viral serologies for people having had blood transfusion or major surgery, surveillance of weight, check of tetanus vaccination, check of influenza vaccination for people aged 65 and over, detection of prostatic disorders for men aged 70 and over, and detection of dementia in people aged 60 and over. RESULTS: 315 patients were examined during the 33 weeks study. The probable malnutrition rate was twice the obesity rate (10.7 vs 5.9%) but detection of obesity was better in the hospital. Tetanus vaccination rate decreased with age and was lower than influenza vaccination rate (59.5 vs 73.0%). Detection of prostatic disorders was only biological. DISCUSSION: The hospital prevention policy could be improved in terms of data collection and transmission of information to the GP's. We dispose of a tool for the measure of secondary prevention, independent of the treatment context, in the hospital. Measurements reveal wide gaps between norms and reality and would help to increase awareness among the health care providers.

Age Factors↗