International Psychogeriatrics

Research Article

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

Paul R. Dubersteina1 c1, Yan Maa1, Benjamin P. Chapmana1, Yeates Conwella1, Joanne McGriffa1, James C. Coynea2, Nathan Franusa1, Marnin J. Heisela1a3, Kimberly A. Kaukeinena1, Silvia Sörensena1, Xin M. Tua1 and Jeffrey M. Lynessa1

a1 University of Rochester Medical Center, Rochester, New York, U.S.A.

a2 University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.

a3 University of Western Ontario, Ontario, Canada

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.

(Received March 16 2010)

(Revised May 04 2010)

(Revised August 06 2010)

(Accepted August 08 2010)

(Online publication September 30 2010)

Correspondence:

c1 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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