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


CONCLUSIONS
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.
Duberstein
Paul R
PR
Department of Psychiatry, University of Rochester Medical Center, Rochester, New York 14642, USA. paul_duberstein@urmc.rochester.edu
Ma
Yan
Y
Chapman
Benjamin P
BP
Conwell
Yeates
Y
McGriff
Joanne
J
Coyne
James C
JC
Franus
Nathan
N
Heisel
Marnin J
MJ
Kaukeinen
Kimberly A
KA
Sörensen
Silvia
S
Tu
Xin M
XM
Lyness
Jeffrey M
JM
D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D003863:Depression / Q000175:diagnosis* / Q000523:psychology; D005190:Family; D005260:Female; D033062:Friends; D006801:Humans; D066298:In Vitro Techniques; D008297:Male; D019964:Mood Disorders / Q000175:diagnosis* / Q000523:psychology; D010551:Personality; D010555:Personality Inventory