Older Age and the Underreporting of Depressive Symptoms

Lyness, Jeffrey M.; Cox, Christopher; Curry, Jennifer R.; Conwell, Yeates; King, Deborah A.; Caine, Eric D.

doi:10.1111/j.1532-5415.1995.tb07325.x

Cited by 192 publications

(122 citation statements)

References 32 publications

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“…(21) is a reliable and validated intervieweradministered measure of depressive symptom severity within the previous week that has been used with older adults in primary care (34). Because the HDRS is not based solely on patient self-report, it reduces measurement problems associated with the underreporting of some depressive symptoms on self-report inventories (36). However, many HDRS items assess somatic symptoms and are likely to be endorsed as a reflection of physical disease, not depression, which could spuriously increase the correlations between the HDRS and the cumulative illness burden.…”

Section: Samplementioning

confidence: 99%

Personality and Medical Illness Burden Among Older Adults in Primary Care

Chapman

Lyness

Duberstein

2007

Psychosomatic Medicine

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Objective-To examine the association between Five Factor Model personality traits (Neuroticism, Extraversion, Openness to experience, Agreeableness, Conscientiousness) and physician-quantified aggregate morbidity in a sample of older adults in primary care.Methods-A total of 449 primary care patients, ranging in age from 65 to 97 years (75 ± 6.9 (mean ± standard deviation)), completed the Neo-Five Factor Inventory (NEO-FFI) and extensive interviews. A physician-investigator completed the Cumulative Illness Rating Scale (CIRS), a well-validated measure of aggregate morbidity based on a review of medical records.Results-Bivariate analyses demonstrated that all five domains of the NEO-FFI were associated with CIRS scores. Multivariate regression controlling for age, gender, education, depression, smoking, hypertension, total cholesterol, alcohol or substance misuse, and other personality traits showed that greater Conscientiousness was independently associated with lower CIRS scores ( = −0.10, t(435) = −1.96, p = .05). Other independent predictors of less morbidity were younger age, absence of hypertension, and lower levels of depression.Conclusion-Our results point toward the necessity of considering Conscientiousness and other personality traits in studies of risk factors for aggregate morbidity. More detailed characterization of at-risk populations will increase the likelihood of constructing informed and effective prevention, intervention, and policy initiatives.

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Section: Samplementioning

confidence: 99%

Personality and Medical Illness Burden Among Older Adults in Primary Care

Chapman

Lyness

Duberstein

2007

Psychosomatic Medicine

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“…In addition, patients with multiple conditions may be overlooked due to the focus on physical rather than mental symptoms [12]. However, this 'crowding out' hypo thesis has been refuted [9]. A common factor may be inadequate time as those with comorbidities often require more time than physicians feel is available.…”

Section: Why Do Physicians Have Difficulty Diagnosing Depression In Tmentioning

confidence: 99%

“…For example, some studies report that older patients may be more likely to believe that depressive symptoms are a normal part of life and may be more reluctant to volunteer psychological or emotional symptoms [9]. It has been stated that late-life depression tends to present with vague symptoms or masked depression (i.e., depression without overt low mood) and it is also widely taught that in older people somatic symptoms may account for higher scores on depression severity measures [10].…”

mentioning

confidence: 99%

Why Do Physicians Have Difficulty Diagnosing Depression in the Elderly?

Mitchell

2011

Aging Health

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“…Physicians may believe that older adults suffering from suicidality are noncompliant with treatment (130) and may tend to be reluctant to refer older patients with depression for mental health care (131). The tendency of older adults to minimize or underreport depressive and suicidal symptoms may further impede risk detection (132)(133)(134)(135). Isometsä and others found that only 11% of those seen in primary care in the month prior to suicide communicated suicidal intent, although this was not exclusive to older adults (136).…”

Section: Randomized Treatment Trials With At-risk Older Adultsmentioning

confidence: 99%

Suicide and its Prevention among Older Adults

Heisel

2006

Can J Psychiatry

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A dults aged 65 years or over have high rates of suicide worldwide (1). Approximately 1.3 die by suicide in Canada every day (2). Older adults have long had high suicide rates (3-7); however, programmatic study of geriatric suicide is relatively recent. The prevalence of late-life suicides may increase as the baby boom cohort reaches retirement age (8), given this population's high suicide rates (9,10) and because they are moving into a phase of life in which rates are high. However, baby boomers' strength in getting health care needs met (11) may help to stem that tide. Geriatric suicidology is in Information on funding and support and author affiliations appears at the end of the article. Clinical Implications· Assessment of risk and resiliency and use of standardized measures, if implemented, might improve suicide risk detection. · Combining antidepressants and interpersonal psychotherapy may help resolve suicide ideation. · Mental health providers are encouraged to collaborate with older patients ' primary care providers, social service workers, and family and other gatekeepers and to employ mental health outreach efforts. Limitations· Risk-factor research has been limited by the statistical rarity of suicide, by the use of diverse inclusion criteria for age, by uncontrolled studies or use of varied control groups, and by little research on resiliency factors. · Few older adult suicide assessment instruments and evidence-based interventions exist. · This review is limited to English-language publications.

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Older Age and the Underreporting of Depressive Symptoms

Cited by 192 publications

References 32 publications

Personality and Medical Illness Burden Among Older Adults in Primary Care

Personality and Medical Illness Burden Among Older Adults in Primary Care

Why Do Physicians Have Difficulty Diagnosing Depression in the Elderly?

Suicide and its Prevention among Older Adults

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