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| Medicine home | About | Future students | Current students | Research | Alumni | Contact us |
| Staff (Intranet) | Staff directory | A-Z index | Site map |
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Research interests
Depression / ECTECT and memory in old age Patients undergoing ECT as a treatment for major depression in aged psychiatry wards are asked to complete tests of verbal, visual and autobiographical memory during and after treatment. This study involved multiple clinical centres in Victoria and findings are being analysed at present. Unilateral vs bilateral ECT in old age: a clinical audit Information will be collected systematically from participating aged mental health services in Victoria regarding the outcomes of patients given unilateral and bilateral ECT as a treatment of major depression. Maintenance ECT: a clinical audit Information was collected systematically from participating aged mental health services in Victoria regarding the characteristics and outcomes of patients undergoing maintenance ECT for treatment of recurrent depression and other mental disorders. Maintenance ECT resulted in a dramatic reduction in days to hospital. Patterns of use of ECT in Victoria A database of ECT administration in Victorian public and private hospitals from 1998 to 2006 will be examined, looking at trends in its application with respect to service settings and patient characteristics. Predicting the outcome of ECT The EEG printouts collected routinely during ECT sessions will be explored using complex statistical analyses to check if neurophysiological markers predict changes in Hamilton Depression Rating Scale scores. Behavioural and psychological symptoms of dementiaA controlled trial of multidisciplinary treatments of agitation in nursing home residents with dementia A team of psychologists and a psychiatrist are conducting detailed assessments of nursing home residents with major depression and developing multi-disciplinary interventions in conjunction with care staff and general practitioners. The effectiveness of the interventions will be tested by means of a randomised, controlled trial. Lavender as a treatment of agitated behaviours in dementia A literature review of psychosocial treatments of behaviour symptoms in dementia identified Lavender and Melissa oils as potentially useful, safe and acceptable. A randomised, controlled, single-blind trial will be conducted of topically-applied Lavender oil in nursing home residents with marked behavioural symptoms. Behaviours will be counted by trained observers before, during and after the treatment and control conditions. Montessori-type activities as a treatment of agitated behaviours in dementia A literature review of psychosocial treatments of behaviour symptoms in dementia identified Montessori activities as a potentially useful, safe and acceptable treatment. These activities are developed in conjunction with families to match the individual interests and skills of nursing home residents. A randomised, controlled trial will be conducted of activities administered by trained volunteers. Behaviours will be counted by trained observers before, during and after the treatment and control conditions. Simulated family presence therapy: a randomised controlled trial in dementia with agitation Relatives of nursing home residents with dementia and severe agitation prepared audiotapes in the style of a telephone conversation directed to the resident. Agitation was measured before, during and after these simulated presence tapes were played through headphones at prescribed intervals. Agitation improved to a modest but statistically significant degree compared with baseline. Tapes of favourite music worked almost as well. Family carers’ responses to behavioural disturbances in dementia Thirty family carers of community-resident older people with dementia provided detailed descriptions of the nature, frequency and severity of behavioural disturbances. These behaviours were common and often stressful. Carers were generally tolerant, except of wandering from home. They responded mostly by ignoring behaviours, avoiding triggers, and providing reassurance, distraction and orientation. A randomised controlled trial of oestrogen as a treatment of aggression in dementia Transdermal oestrogen patches were prescribed to 27 elderly men with severe dementia and aggression as part of an 8-week randomised, controlled trial. There were no adverse effects but the treatment resulted in no significant improvement in levels of aggression, possibly because of unreliable absorption of the medication. A controlled trial of multidisciplinary treatments of agitation in nursing home residents with dementia A psychiatrist, psychologist and nurses conducted detailed assessments of 99 nursing home residents with disturbed behaviours to identify likely triggers and treatments. Individually-tailored management plans were then implemented in a controlled fashion. Interventions, which included psychosocial therapies, new nursing approaches, analgesia and psychiatric medications in descending frequency, resulted in modest but statistically significant reductions in target behaviours. Primary careThe recognition and management of depression in elderly general practice patients Thirty general practitioners (GPs) rated the mood of 1020 of their patients aged 70+ years who were then assessed in detail using the Canberra Interview for the Elderly. Only half of patients with moderate or severe major depressive episodes had reported any symptoms to their doctors. Similarly, doctors recognised only half the cases of moderate or severe depression under their care. Residential careCommunication, quality of life and psychotropic medication use in Italian and Greek nursing home residents with dementia Elderly nursing home residents with dementia who were born in Italy or Greece and who live in mainstream or ethno-specific nursing homes will be compared with respect to verbal interactions with staff and co-residents, their quality of life, and their use of psychotropic medications. Language of older Italians with dementia in mainstream or ethno-specific residential care Italian-background persons with dementia living in Italian-specific aged residential facilities communicated more with others, and were less likely to be prescribed day-time benzodiazepines, than their peers in mainstream facilities. People with dementia and limited English language proficiency may derive particular benefit from additional language-relevant resources and social stimulation. Language use and language-relevant service provision in aged residential care A postal survey of all aged care facilities in south-east Melbourne showed that most had residents who preferred or needed to speak one of 40 different languages. While interpreters, language boards and books were all used, there is a need for more wide-spread use of appropriate resources to cater for this growing population. Language-relevant interventions for older Italians with dementia and behavioural disturbance Three older Italian-background persons with severe dementia who were verbally disruptive took part in a randomly ordered intervention program, comparing social interaction in English or Italian. Normal, non-disruptive communication increased when the interaction was in Italian, suggesting that communication in residents' native language is beneficial even in very severe dementia. Depression in nursing home residents: prevalence and natural history Fifty nursing home residents were assessed at admission and periodically thereafter using the Cornell Scale for Depression in Dementia. Almost a quarter were diagnosed with a DSM-IV major depressive disorder. Most were markedly cognitively impaired and would have been missed using standard assessment tools. Once established, depression was usually persistent. These findings suggest that most previous studies have significantly under-estimated rates of depression in aged residential facilities and that depression does not remit spontaneously. Aged mental health servicesDepressed patients' recollections of admission to an aged psychiatry inpatient unit This study investigated how hospitalisation is experienced by elderly people who are admitted to an acute aged psychiatry ward with major depression. Fifty former patients of three psychiatric units were interviewed at home after discharge. A third described distressing events and/or episodes of feeling frightened, unsafe or powerless. Most participants had positively re-evaluated their experience and only 8% reported continuing distress. Old age psychiatrists’ preferred medications to treat behavioural and psychological symptoms of dementia Members of the Faculty of Psychiatry of Old Age rated their preferred medical treatments of behavioural and psychological symptoms of dementia. Atypical antipsychotics were rated by most as treatment of choice for dementia complicated by psychosis, aggression, sundowning and persistent yelling. Opinions varied widely regarding management of other symptoms. Physical restraint and seclusion in aged psychiatry inpatient units Comparisons were made of the use of physical restraint and seclusion in five acute aged psychiatry wards in Melbourne. Rates varied widely but fell over the next year, suggesting that staff practice is amenable to change by means of benchmarking with comparable facilities. Aged mental health services in Australia and New Zealand A mapping exercise was conducted on behalf of the Faculty of Psychiatry of Old Age of all specialist aged mental health services in Australia and New Zealand. Services varied widely in their size and scope from one State to another. It is hoped that this information will spur States to make better provision for older people with mental disorders. Drug-studiesThe Unit has contributed to the following multi-centre drug trials:
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