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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
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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: paul_duberstein@urmc.rochester.edu.
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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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