Emad Salib

HEAD INJURY AND THE RISK OF ALZHEIMER'S DISEASE: A CASE CONTROL STUDY

Objectives. The objective of this study is to examine the association between Alzheimers disease and head injury in elderly patients referred to an EMI unit.

The khat users: a study of khat chewing in Liverpool's Somali men.

This study reports the demographic and social characteristics and level of psychological dysfunction in regular khat users compared with matched non-users. The results indicate that khat users resemble non-users on a number of psychosocial variables and GHQ scores, with no evidence to suggest higher morbidity amongst users. The two groups appear to differ only in the level of their use of nicotine and also in their perception of the harmful effects associated with khat use.

Practice of Seclusion: A Five-Year Retrospective Review in North Cheshire

This study examines, retrospectively, the trends and factors associated with the use of seclusion over a five-year period in a regional secure unit located within a large psychiatric hospital that serves the population of North Cheshire. Ninety-four patients (15.3% of total admissions to the unit) spent some time in seclusion on 186 occasions. The average time spent in seclusion was 85 minutes (minimum 15 minutes and maximum 10 hours). Sixty-seven per cent of patients were secluded once, 20% secluded twice, and 13% more than three times. Patients with a clinical diagnosis of personality disorder (11.4%) accounted for 44.2% of seclusions whereas those with a defined mental disorder (55%) accounted for 35% of all seclusions. The rate of seclusion, characteristics of secluded patients, reasons, and average duration spent in seclusion, did not vary significantly over the study period, despite the significant reduction of the units admission rate from 150 to 63 per year. The consistent and regular occurrence of the practice over a five-year period may suggest that seclusion of some disturbed patients will inevitably continue to be used as an effective intervention and, probably at times, the only acceptable method that may ensure the safety of patients and staff.

Elderly suicide and weather conditions: is there a link?

Background. Studies of the effect of meteorological factors on suicide have yielded inconclusive and often contradictory results. This may be due to a variety of methodological problems including small numbers and variability in the definition of suicide. The relationship has not been examined in the elderly.

Elderly suicide: an analysis of coroner's inquests into two hundred cases in Cheshire 1989 - 2001

Elderly suicide is an index of more widespread disorder and discontent among the elderly, and furthermore is a potentially preventable cause of death. This study used coroners inquest records of 200 elderly in Cheshire who killed themselves, and in which their unexpected deaths attracted a verdict of suicide. Sociodemographic characteristics, clinical aspects of the suicidal process and health care contact before death are reviewed. Unlike most available studies, cases of unexpected death in which an open verdict was given were not included in this study, which covered a 13 year period. The findings are interpreted and compared to the currently available literature on suicide in the elderly. Late life suicide is characterised by less warning, higher lethality and greater prevalence of depression and physical illness. However, suicide risk often remains undetected. All suicidal behaviour in the elderly should be taken seriously by psychiatric and primary care services, in order to reduce suicide rates in the elderly.

Factors predicting 30-day readmission after laparoscopic colorectal cancer surgery within an enhanced recovery programme.

Hospital readmission within 30 days of surgery has become a marker of poor quality patient care. This study aimed to investigate factors predictive of 30‐day readmission after laparoscopic colorectal cancer surgery within an enhanced recovery after surgery (ERAS) programme.

Elderly suicide and attempted suicide: one syndrome.

In this study we explore whether elderly suicide victims who had a previous history of attempted suicide differ from those with no similar history. A group of the elderly, who ended their lives with fatal self-harm (FSH) and had a history of deliberate self-harm (DSH) was compared to a matching group of the elderly who also ended their lives with FSH, but who were not known to have had any history of DSH. The comparison was in respect of epidemiological, social, psychological characteristics, service input and methods of suicide. The elderly, with a history of DSH, were more likely to have been known to the mental health services than the elderly who did not have such a history (P<.05). The two groups used similar methods in their final FSH act. The elderly victims of FSH with or without a previous history of DSH share the same characteristics. The two groups appear to be part of one syndrome. Deliberate self-harm in the elderly should be taken seriously as an unsuccessful suicide rather than a manipulative act or a cry for help and attention.

Age and methods of fatal self harm (FSH). Is there a link

Objectives. To examine the methods of fatal self harm (FSH) used by the elderly compared to young adults.

Coroner's verdicts in the elderly: a suicide or an open verdict?

Objectives. To identify variables, other than legal definitions, that may have influenced North Cheshires Coroner in returning a verdict of ‘suicide’ or an ‘open verdict’ on unexpected deaths of the elderly.

Relative humidity and affective disorders.

INTRODUCTION: Looking at specific weather parameters over a period of time prior to hospital admissions may provide evidence of a link between weather conditions and some psychiatric conditions such as affective disorders. We examined the association between relative humidity (as well as other parameters such as sunshine hours, diurnal variations in temperature and rainfall) and psychiatric admissions in North Cheshire, UK. METHOD: The daily numbers of all psychiatric admissions in North Cheshire in a specified year were analysed in relation to meteorological data, which were measured at the meteorological office nearest to the study population. RESULTS: We found a significant inverse relationship (with time lag) between admissions for affective disorders and relative humidity in the week preceding admission. Changes in diurnal variations in temperature, sunshine hours and rainfall a few days before admission were also noted, but the findings did not achieve statistical significance for any diagnostic category. CONCLUSION: The effect of weather parameters on mental health is likely to be influenced by other seasonal factors, as well as non-climatic factors, predominantly social, that may have contributed to the study findings. Psychiatric admissions reflect the behaviour of patients, carers and medical professionals. The complexity of this behaviour and the day-of-the-week periodicity may have confounded variations associated with the weather. (Int J Psych Clin Pract 2002; 6: 147-153 )