title: Characteristics of depression in community-dwelling elderly people as indicated by the tree-drawing test.
abstract: BACKGROUND
  The tree-drawing test (TDT) is a typical projective method, but previous studies have paid little attention to it for elderly people. We investigated the characteristics of depression in community-dwelling elderly people as indicated by the TDT.
  
  
  METHODS
  This study was a complete enumeration survey of elderly people conducted through home visits. The contents of the survey included gender, age, presence or absence of housemates, frequency of going out, the 15-item Geriatric Depression Scale, and TDT. The subjects were divided into three groups (normal, depressed tendency, and depressed) according to the total 15-item Geriatric Depression Scale score.
  
  
  RESULTS
  In TDT, no significant difference was observed in drooping crown, shadow of the whole tree, or shadow near the base, which have been regarded as indices of depression in younger people. However, the values concerning the size of the tree, such as the height and width of the whole tree, height and width of the crown, and number of occupied areas (of the paper), were significantly lower in the depressed group than in the other groups. In addition, the width of the trunk was significantly smaller in the depressed group than in the normal group. Subjects were classified as being in a 'depressed state' if they used 40 or fewer areas for drawing (i.e. occupied areas) and a 'non-depressed state' if they used 41 or more areas. This enabled depression to be detected (sensitivity: 71.4%; specificity: 79.9%).
  
  
  CONCLUSIONS
  The size of the tree in TDT is suggested to reflect characteristics of depression in elderly people, such as introversion, reserve, antisocial attitude, a feeling of inferiority, weakness of ego, and lack of vigour. Furthermore, the numbers of occupied areas were found to be relatively useful in detecting depression in elderly people.
authors.affiliation: School of Allied Health Sciences, Kitasato University, Kanagawa, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Murayama
authors.affiliation: Faculty of Social Welfare, Nagano University, Nagano, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Endo
authors.affiliation: Faculty of Social Welfare, Nagano University, Nagano, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Inaki
authors.affiliation: College of Humanities and Sciences, Nihon University, Tokyo, Japan.
authors.forename: Shinsai
authors.initials: S
authors.lastname: Sasaki
authors.affiliation: School of Allied Health Sciences, Kitasato University, Kanagawa, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Fukase
authors.affiliation: PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan.
authors.forename: Kazumi
authors.initials: K
authors.lastname: Ota
authors.affiliation: PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan.
authors.forename: Eizo
authors.initials: E
authors.lastname: Iseki
authors.affiliation: School of Allied Health Sciences, Kitasato University, Kanagawa, Japan.
authors.forename: Hirokuni
authors.initials: H
authors.lastname: Tagaya
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012680:Sensitivity and Specificity; D014197:Trees
keywords: Baum test; Geriatric Depression Scale (GDS); complete enumeration survey; depression; tree-drawing test (TDT)