Family and Friends Help Detect Depression in Sunny Seniors

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Family and friends are often involved in the care of older adults, frequently accompanying them on visits to their doctors. Because of that, it’s key to elder care for those close to them to be able to tell when something’s wrong. A recent study that examined the accuracy of family and friends’ reports of depression in older patients found that accuracy was tied to the patient’s personality type.

The study recruited relatives and friends of older adults already enrolled in a study of mental disorders in primary care patients age 65 and over. Patient and relative pairs (191 of them) participated in the study. Patients completed questionnaires and responded to verbal assessments that measured neuroticism, extraversion, openness, agreeableness, and conscientiousness. Based on the interview data and patient’s medical chart, psychiatric diagnoses of depression were established for patients. Friends and relatives were given clinical interviews both in regard to the older patient and as if they were the patient. Best-estimate psychiatric diagnoses were given based on each of these interviews

The study found that on the whole specificity of family and friends’ reports was better when patients were more extraverted and agreeable; specificity was worse when patients were more conscientious. So, it was more likely for family and friends to incorrectly think patients were depressed when patients were disagreeable, more introverted, and/or dependable and achievement-oriented. Sensitivity of depression diagnoses was lower when patients were more extraverted and agreeable. So, more extraverted and agreeable patients were more likely to be inaccurately considered non-depressed.

The study’s findings suggest that agreeable, extroverted patients might mask depression with their higher levels of energy, sociability and optimism. Since people usually associate depression with withdrawal, friends and family may not pick up on depression if their loved one doesn’t socially isolate. Study leaders were surprised to find that more conscientious patients were more likely to be incorrectly perceived to be depressed. The result may imply that individuals are thought to be depressed when they are really just becoming less dependable and task-oriented as they age.

Given the possibly grave consequences of failure to detect depression, the study findings suggest that health care providers need to be even more vigilant when interpreting family/friend reports about patients who have sunny dispositions.

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