title: Detection of depression in older adults by family and friends: distinguishing mood disorder signals from the noise of personality and everyday life.
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.
  
  
  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.
authors.affiliation: Department of Psychiatry, University of Rochester Medical Center, Rochester, New York 14642, USA. paul_duberstein@urmc.rochester.edu
authors.forename: Paul R
authors.initials: PR
authors.lastname: Duberstein
authors.forename: Yan
authors.initials: Y
authors.lastname: Ma
authors.forename: Benjamin P
authors.initials: BP
authors.lastname: Chapman
authors.forename: Yeates
authors.initials: Y
authors.lastname: Conwell
authors.forename: Joanne
authors.initials: J
authors.lastname: McGriff
authors.forename: James C
authors.initials: JC
authors.lastname: Coyne
authors.forename: Nathan
authors.initials: N
authors.lastname: Franus
authors.forename: Marnin J
authors.initials: MJ
authors.lastname: Heisel
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Kaukeinen
authors.forename: Silvia
authors.initials: S
authors.lastname: Sörensen
authors.forename: Xin M
authors.initials: XM
authors.lastname: Tu
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Lyness
mesh_terms: 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