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Detection of depression in older adults by family and friends: distinguishing mood disorder signals from the noise of personality and everyday life

Published online by Cambridge University Press:  30 September 2010

Paul R. Duberstein ,
Yan Ma ,
Benjamin P. Chapman ,
Yeates Conwell ,
Joanne McGriff ,
James C. Coyne ,
Nathan Franus ,
Marnin J. Heisel ,
Kimberly A. Kaukeinen  and
Silvia Sörensen
...Show all authors
Paul R. Duberstein*
Affiliation:
University of Rochester Medical Center, Rochester, New York, U.S.A.
Yan Ma
Affiliation:
University of Rochester Medical Center, Rochester, New York, U.S.A.
Benjamin P. Chapman
Affiliation:
University of Rochester Medical Center, Rochester, New York, U.S.A.
Yeates Conwell
Affiliation:
University of Rochester Medical Center, Rochester, New York, U.S.A.
Joanne McGriff
Affiliation:
University of Rochester Medical Center, Rochester, New York, U.S.A.
James C. Coyne
Affiliation:
University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.
Nathan Franus
Affiliation:
University of Rochester Medical Center, Rochester, New York, U.S.A.
Marnin J. Heisel
Affiliation:
University of Rochester Medical Center, Rochester, New York, U.S.A. University of Western Ontario, Ontario, Canada
Kimberly A. Kaukeinen
Affiliation:
University of Rochester Medical Center, Rochester, New York, U.S.A.
Silvia Sörensen
Affiliation:
University of Rochester Medical Center, Rochester, New York, U.S.A.
Xin M. Tu
Affiliation:
University of Rochester Medical Center, Rochester, New York, U.S.A.
Jeffrey M. Lyness
Affiliation:
University of Rochester Medical Center, Rochester, New York, U.S.A.
*
Correspondence should be addressed to: Paul R. Duberstein, University of Rochester Medical Center, Box PSYCH, Department of Psychiatry, 300 Crittenden Boulevard, Rochester, NY 14642, U.S.A. Phone: +1 (585) 275-6742; Fax: +1 (585) 273-1082. Email: [email protected].
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Abstract

Background: The capacity of friends and family member informants to make judgments about the presence of a mood disorder history in an older primary care patient has theoretical, clinical, and public health significance. This study examined the accuracy of informant-reported mood disorder diagnoses in a sample of primary care patients aged 65 years or older. We hypothesized that the accuracy (sensitivity and specificity) of informant reports would vary with the patient's personality.

Methods: Hypotheses were tested in 191 dyads consisting of patients and their friends or relatives (informants) recruited from primary care settings. Gold-standard mood disorder diagnoses were established at consensus conferences based on a review of medical charts and data collected in a structured interview with the patient. Patients completed an assessment battery that included the NEO-Five Factor Inventory.

Results: Sensitivity and specificity of informant-derived mood disorder diagnoses were related to patient personality. Sensitivity of informant-derived lifetime mood disorder diagnoses was compromised by higher Extraversion and higher Agreeableness. Specificity of informant-derived lifetime mood disorder diagnoses was compromised by lower Agreeableness and higher Conscientiousness.

Conclusion: Patient personality has implications for the accuracy of mood disorder histories provided by friends and family members. Given that false negatives can have grave consequences, we recommend that practitioners be particularly vigilant when interpreting collateral information about their extraverted, agreeable patients.

Keywords

personalitydepressioninformantsprimary care
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 4 , May 2011 , pp. 634 - 643
Copyright
Copyright © International Psychogeriatric Association 2010

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References

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. Washington, DC: American Psychiatric Association.Google Scholar
Brugha, T. S., Bebbington, P. E. and Jenkins, R. (1999). Difference that matters: comparisons of structured and semi-structured psychiatric diagnostic interviews in the general population. Psychological Medicine, 29, 1013–1020.CrossRefGoogle ScholarPubMed
Chapman, B. P., Duberstein, P. R., Sörensen, S. and Lyness, J. M. (2006). Personality and perceived health in older adults: the Five Factor Model in primary care. Journals of Gerontology: Series B, Psychological Sciences and Social Sciences, 61, P362–P365.CrossRefGoogle ScholarPubMed
Chapman, B. P., Duberstein, P. R. and Lyness, J. M. (2007). Personality traits, education, and health related quality of life among older adults. Journals of Gerontology: Series B Psychological Sciences and Social Sciences, 62B, P343–P352.CrossRefGoogle Scholar
Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement, 20, 37–46.CrossRefGoogle Scholar
Colvin, C. R. (1993). ‘Judgable’ people: personality, behavior, and competing explanations. Journal of Personality and Social Psychology, 64, 861–873.CrossRefGoogle ScholarPubMed
Conwell, Y., Forbes, N. T., Cox, C. and Caine, E. D. (1993). Validation of a measure of physical illness burden at autopsy: the Cumulative Illness Rating Scale. Journal of the American Geriatrics Society, 41, 38–41.CrossRefGoogle ScholarPubMed
Costa, P. T. Jr. and McCrae, R. R. (1992). Revised NEO Personality Inventory and NEO Five Factor Inventory: Professional Manual. Odessa, FL: Psychological Assessment Resources.Google Scholar
Costa, P. T. Jr., Bagby, M. R., Herbst, J. H. and McCrae, R. R. (2005). Personality self-reports are concurrently reliable and valid during acute depressive episodes. Journal of Affective Disorders, 89, 45–55.CrossRefGoogle ScholarPubMed
Cowen, E. L. (1982). Help is where you find it: Four informal helping groups. American Psychologist, 37, 385–395.CrossRefGoogle Scholar
Cui, X., Lyness, J. M., Tang, W., Tu, X. and Conwell, Y. (2008). Outcomes and predictors of late-life depression trajectories in older primary care patients. American Journal of Geriatric Psychiatry, 16, 406–415.CrossRefGoogle ScholarPubMed
Domken, M., Scott, J. and Kelly, P. (1994). What factors predict discrepancies between self and observer ratings of depression? Journal of Affective Disorders, 31, 253–259.CrossRefGoogle ScholarPubMed
Duberstein, P. R. (2001). Are closed-minded people more open to the idea of killing themselves? Suicide and Life Threatening Behavior, 31, 9–14.CrossRefGoogle Scholar
Duberstein, P. R. and Heisel, M. J. (2007). Personality traits and the reporting of affective disorder symptoms in depressed patients. Journal of Affective Disorders, 103, 165–171.CrossRefGoogle ScholarPubMed
Duberstein, P. R. et al. (2003). Personality is associated with perceived health and functional status in older primary care patients. Psychology and Aging, 18, 25–37.CrossRefGoogle ScholarPubMed
Enns, M. W., Larsen, D. and Cox, B. J. (2000). Discrepancies between self and other ratings of depression: The relationship to demographic, clinical and personality variables. Journal of Affective Disorders, 30, 33–41.CrossRefGoogle Scholar
Epstein, R. M. et al. (2010). “I didn't know what was wrong”: how people with undiagnosed depression recognize, name and explain their distress. Journal of General Internal Medicine, 25, 954–961.CrossRefGoogle ScholarPubMed
First, M. B., Spitzer, R. L., Gibbon, M. and Williams, J. B. W. (2002). Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition (SCID-I/P). New York: Biometrics Research.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Funder, D. C. (1995). On the accuracy of personality judgment: a realistic approach. Psychological Review, 102, 652–670.CrossRefGoogle ScholarPubMed
García Márquez, G. (2006). Memories of My Melancholy Whores. New York: Vintage International.Google Scholar
Geerts, E. and Bouhuys, N. (1998). Multi-level prediction of short-term outcomes of depression: non-verbal interpersonal processes, cognitions, and personality traits. Psychiatry Research, 79, 59–72.CrossRefGoogle ScholarPubMed
Goodwin, R. D., Hoven, C. W., Lyons, J. S. and Stein, M. B. (2002). Mental health service utilization in the United States: the role of personality factors. Social Psychiatry and Psychiatric Epidemiology, 37, 561–566.CrossRefGoogle ScholarPubMed
Gordis, L. (1996). Epidemiology. Philadelphia, PA: Saunders.Google Scholar
Heun, R., Burkart, M. and Maier, W. (1995). Selection biases during recruitment of patients and relatives for a family study in the elderly. Journal of Psychiatric Research, 29, 491–504.CrossRefGoogle ScholarPubMed
Heun, R., Hardt, J., Burkart, M. and Maier, W. (1996). Validity of the family history method in relatives of gerontopsychiatric patients. Psychiatry Research, 62, 227–238.CrossRefGoogle ScholarPubMed
Heun, R., Maier, W. and Muller, H. (1997). Subject and informant variables affecting family history diagnoses of depression and dementia. Psychiatry Research, 71, 175–180.CrossRefGoogle Scholar
Hooker, K., Monahan, D. J., Bowman, S. R., Frazier, L. D. and Shifren, K. (1998). Personality counts for a lot: predictors of mental and physical health of spouse caregivers in two disease groups. Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 53B, 73–85.CrossRefGoogle Scholar
Horwitz, A. V. and Wakefield, J. C. (2007). The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder. New York: Oxford University Press.CrossRefGoogle Scholar
Krueger, J., Ham, J. J. and Linford, K. M. (1996). Perceptions of behavioral consistency: are people aware of the actor-observer effect? Psychological Science, 7, 259–264.CrossRefGoogle Scholar
Krueger, K. R., Wilson, R. S., Shah, R. C., Tang, Y. and Bennett, D. A. (2006). Personality and incident disability in older persons. Age and Ageing, 35, 428–433.CrossRefGoogle ScholarPubMed
Landerman, R., George, L. K., Campbell, R. T. and Blazer, D. G. (1989). Alternative models of the stress-buffering hypothesis. American Journal of Community Psychology, 17, 625–642.CrossRefGoogle ScholarPubMed
Lantz, C. A. and Nebenzahl, E. (1996). Behavior and interpretation of the K statistic: resolution of the two paradoxes. Journal of Clinical Epidemiology, 49, 431–434.CrossRefGoogle Scholar
Levine, M. (1998). Prevention and community. American Journal of Community Psychology, 26, 189–206.CrossRefGoogle Scholar
Levy, B. R. (2002). Mind matters: cognitive and physical effects of aging self-stereotypes. Journals of Gerontology: Series B, Psychological Sciences and Social Sciences, 58B, P203–P211.Google Scholar
Liang, K. Y. and Zeger, S. L. (1986). Longitudinal data analysis using generalized linear models. Biometrika, 73, 13–22.CrossRefGoogle Scholar
Linn, B. S., Linn, M. W. and Gurel, L. (1968). Cumulative illness rating scale. Journal of the American Geriatrics Society, 16, 622–626.CrossRefGoogle ScholarPubMed
Maxwell, W. E. (1977). Coefficients of agreement between observers and their interpretation. British Journal of Psychiatry, 130, 79–83.CrossRefGoogle ScholarPubMed
McCray, L. W., Bogner, H. R., Sammel, M. D. and Gallo, J. J. (2007). The role of patient personality in the identification of depression in older primary care patients. International Journal of Geriatric Psychiatry, 22, 1095–1100.CrossRefGoogle ScholarPubMed
Pepe, M. S. and Anderson, G. L. (1994). A cautionary note on inferences for marginal regression models with longitudinal data and general correlated response. Communications in Statistical Theory and Methods, 23, 939–951.Google Scholar
Pescosolido, B. A. (1992). Beyond rational choice: The social dynamics of how people seek help. American Journal of Sociology, 97, 1096–1138.CrossRefGoogle Scholar
Sarkisian, C. A., Lee-Henderson, M. H. and Mangione, C. M. (2003). Do depressed older adults who attribute depression to “old age” believe it is important to seek care? Journal of General Internal Medicine, 18, 1001–1005.CrossRefGoogle ScholarPubMed
SAS/STAT Software (2006). Changes and Enhancements Through Release 8. Cary, NC: SAS Institute, Inc.Google Scholar
Sirey, J. A. et al. (2001). Perceived stigma as a predictor of treatment discontinuation in young and older outpatients with depression. American Journal of Psychiatry, 158, 479–481.CrossRefGoogle Scholar
Skoog, I. et al. (1996). Suicidal feelings in a population sample of nondemented 85-year-olds. American Journal of Psychiatry, 153, 1015–1020.Google Scholar
Tai-Seale, M., McGuire, T., Colenda, C., Rosen, D. and Cook, M. A. (2007). Two-minute mental health care for elderly patients: inside primary care visits. Journal of the American Geriatrics Society, 55, 2083–2085.CrossRefGoogle ScholarPubMed
ten Have, M., Oldehinkel, A., Vollebergh, W. and Ormel, J. (2005). Does neuroticism explain variations in care service use for mental health problems in the general population? Social Psychiatry and Psychiatric Epidemiology, 40, 425–431.CrossRefGoogle ScholarPubMed
Wittchen, H. U., Üstün, T. B. and Kessler, R. C. (1999). Diagnosing mental disorders in the community: a difference that matters? Psychological Medicine, 29, 1021–1027.CrossRefGoogle ScholarPubMed
Wolff, J. L. and Roter, D. L. (2008). Hidden in plain sight: medical visit companions as a resource for vulnerable adults. Archives of Internal Medicine, 168, 1409–1415.CrossRefGoogle Scholar