title: Investigating Factors that Bias the Reporting of Depression Symptomatology Among Older Australian Adults.
abstract: OBJECTIVE
  To investigate factors that may bias the reporting of major depression symptoms among older adults, specifically the presence of physical conditions, bereavement, episode onset, and episode length.
  
  
  METHODS
  A secondary data analysis of a nationally representative cross-sectional survey of community-dwelling older Australian adults aged 50-85 years who completed the depression module in the 2007 Australian National Survey of Mental Health and Wellbeing (N=629) was conducted. Depression symptomatology was assessed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria using the World Mental Health Composite International Diagnostic Interview.
  
  
  RESULTS
  Multiple indicators multiple causes modeling indicated a unidimensional factor structure of depression. Two depressive symptoms displayed measurement noninvariance (i.e., nonequivalency): worthlessness/guilt and suicidality/thoughts of death. Specifically, older adults who were bereaved were significantly less likely to report worthlessness/guilt (OR: 0.29; 95% CI: 0.16-0.50) and more likely to report suicidality/thoughts of death (OR: 4.67; 95% CI: 2.84-7.68), compared with older adults who were not bereaved. Examination of latent mean differences revealed that older adults with physical conditions displayed significantly greater depression severity compared with older adults without physical conditions.
  
  
  CONCLUSIONS
  The presence of physical conditions and episode onset and length do not appear to differentially influence reporting of depression symptoms among older Australian adults, suggesting these factors do not bias prevalence estimates of depression. Reporting of worthlessness/guilt and suicidality/thoughts of death may be biased toward older adults who are bereaved; however, these did not influence overall depression severity.
authors.affiliation: NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Heather
authors.initials: H
authors.lastname: Buchan
authors.affiliation: NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia. Electronic address: matthews@unsw.edu.au.
authors.forename: Matthew
authors.initials: M
authors.lastname: Sunderland
authors.affiliation: NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Natacha
authors.initials: N
authors.lastname: Carragher
authors.affiliation: NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Eva
authors.initials: E
authors.lastname: Louie
authors.affiliation: National Institute for Mental Health Research, The Australian National University, Canberra, Australian Capital Territory, Australia.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Batterham
authors.affiliation: NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Tim
authors.initials: T
authors.lastname: Slade
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D001601:Bereavement; D015982:Bias; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D003865:Major Depressive Disorder / Q000453:epidemiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006167:Guilt; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D008960:Models, Psychological; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D059020:Suicidal Ideation
keywords: Depressive symptoms; epidemiology; older adults