Assessment of depression in patients with Alzheimer's disease: concordance among informants.

This study is an investigation of the concordance among different sources of information on ratings of depression in patients with Alzheimer's disease (AD). Informants were 75 outpatients with diagnosed AD (22 with major depressive disorder), their caregivers, and geriatric clinicians. Clinicians rated each patient on the Hamilton Rating Scale for Depression on the basis of (a) the patient's report, (b) the caregiver's report, and (c) the clinician's evaluation. Overall, patients perceived themselves as less depressed than did caregivers or clinicians; for nondepressed patients, caregivers reported patients less depressed than clinicians reported; for depressed patients, no significant differences were obtained between caregiver or clinician. Certain items were more discrepant among informants and significantly differentiated depressed from nondepressed AD patients. Level of patient dementia did not affect ratings. These findings support the need for comprehensive, accurate assessment of depression in AD patients.

[1]  M M Weissman,et al.  Children's Symptom and Social Functioning Self-Report Scales Comparison of Mothers' and Children's Reports , 1980, The Journal of nervous and mental disease.

[2]  M. Hamilton,et al.  Development of a rating scale for primary depressive illness. , 1967, The British journal of social and clinical psychology.

[3]  J. Prothero,et al.  The Alzheimer's Caregiver: Strategies for Support , 1987 .

[4]  A. Kazdin,et al.  Child, mother, and father evaluations of depression in psychiatric inpatient children , 1983, Journal of abnormal child psychology.

[5]  B. Reisberg,et al.  The Global Deterioration Scale for assessment of primary degenerative dementia. , 1982, The American journal of psychiatry.

[6]  L. Teri,et al.  Double-blind trial of imipramine in Alzheimer's disease patients with and without depression. , 1989, The American journal of psychiatry.

[7]  R. Gur,et al.  Reliability of psychiatric scales in patients with dementia of the Alzheimer type. , 1988, The American journal of psychiatry.

[8]  L. Lazarus,et al.  Frequency and presentation of depressive symptoms in patients with primary degenerative dementia. , 1987, The American journal of psychiatry.

[9]  J. Biggs,et al.  Validity of the Hamilton Rating Scale for Depression , 1977, British Journal of Psychiatry.

[10]  J. Barrett,et al.  Psychopathology in the aged , 1980 .

[11]  L. Teri,et al.  Functional Status and Cognitive Impairment in Alzheimer's Patients With and Without Depression , 1989, Journal of the American Geriatrics Society.

[12]  J. Harmatz,et al.  A New Scale for Clinical Assessment in Geriatric Populations: Sandoz Clinical Assessment – Geriatric (SCAG) * , 1974, Journal of the American Geriatrics Society.

[13]  G. R. Leon,et al.  Depression in children: Parent, teacher, and child perspectives , 1980, Journal of abnormal child psychology.

[14]  M. Hamilton.  A RATING SCALE FOR DEPRESSION , 1960, Journal of neurology, neurosurgery, and psychiatry.

[15]  M. Roth,et al.  The Association Between Quantitative Measures of Dementia and of Senile Change in the Cerebral Grey Matter of Elderly Subjects , 1968, British Journal of Psychiatry.

[16]  M. Drake.  Diagnostic and Statistical Manual of Mental Disorders (3rd ed. rev.) , 1988 .

[17]  J. White,et al.  Effects of endogenicity and severity on consistency of standard depression rating scales. , 1984, The Journal of clinical psychiatry.

[18]  Laura L. Carstensen,et al.  Handbook of clinical gerontology , 1987 .

[19]  E. Larson,et al.  An outpatient geriatric psychiatry assessment and treatment service. , 1987, Clinics in geriatric medicine.

[20]  Miller Ne.  The measurement of mood in senile brain disease: examiner ratings and self-reports. , 1980 .