Influence of cognitive impairment, illness, gender, and African-American status on psychiatric ratings and staff recognition of depression.
OBJECTIVE
The authors examined the multivariate relationships between depression recognition by staff members and characteristics of nursing home residents.


METHODS
Analyses used a simple random sample of 270 residents, drawn from six randomly selected nursing homes, who were evaluated by psychiatrists for depression and depressive symptomatology.


RESULTS
African Americans were generally seen by psychiatrists as having less depressive symptomatology than residents from other ethnic groups. The data suggest that nurse aides, perhaps because they see residents more often or because they are less influenced by demographic characteristics, may be the most valid source of information about residents' depression. In contrast, after partialing out the degree of depression severity, nurses tended to overrecognize depression among African-American residents. Social workers underrecognized depression among residents with cognitive impairment and/or Parkinson disease and among women, and overrecognized depression among African Americans.


CONCLUSIONS
The results underline the need for more training in depression recognition, particularly in distinguishing social from clinical phenomena and in distinguishing symptoms of dementia from those of depression. Equally important is further investigation of the potential biases associated with diagnosis and recognition of depression among African Americans.
Teresi
Jeanne A
JA
Research Division, Hebrew Home for the Aged at Riverdale, 5901 Palisade Avenue, Riverdale, NY 10471, USA.
Abrams
Robert
R
Holmes
Douglas
D
Ramirez
Mildred
M
Shapiro
Carol
C
Eimicke
Joseph P
JP
D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000523:psychology*; D003866:Depressive Disorder / Q000523:psychology*; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009518:New York; D011569:Psychiatric Status Rating Scales; D012737:Sex Factors