Characteristics of depression in neurologically impaired and normal elderly.

Persistent Link:
http://hdl.handle.net/10150/184817
Title:
Characteristics of depression in neurologically impaired and normal elderly.
Author:
Downer, Patricia.
Issue Date:
1989
Publisher:
The University of Arizona.
Rights:
Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
Abstract:
Severity and pattern of depressive symptomatology were examined among four groups of elderly individuals, i.e., patients with DSM-III diagnoses of major depression (n = 54), patients with presumed dementia of the Alzheimer's type (DAT) (n = 27), patients with idiopathic Parkinson's disease (PD) (n = 30), and normal controls (n = 29). The depressed elderly group obtained significantly (p < .001) higher means, and the control group obtained significantly (p < .01) lower means, than the neurologically impaired groups on clinician ratings (Hamilton Rating Scale for Depression, HRS-D) and self-report (Beck Depression Inventory, BDI) of depression. However, HRS-D means of the PD and DAT groups did not differ significantly (p < .125). The depressed elderly group also obtained significantly (p < .001) higher means than the contrast groups on HRS-D vegetative and cognitive depression primary factors (adapted from Rhoades & Overall, 1983), while the control group obtained significantly (p < .001 to 0.01) lower means. At the intermediate level, the PD mean on the vegetative factor was significantly (p < .05) higher than the DAT mean, while the groups did not differ significantly (p < .79) on the cognitive factor. The depressed elderly group obtained a substantially lower interfactor correlation coefficient than the neurologically impaired groups, suggesting greater heterogeneity in manifestation of depression at moderate than at mild levels of severity. However, the finding of zero variance on some HRS-D items for the neurologically impaired groups suggested that factor structures may differ for PD, DAT, and depressed groups. For PD patients, the prediction that PD symptom severity ratings would correlate more highly with clinician ratings (HRS-D) than self-report (BDI) of depression, due to PD symptoms that resemble depression, was not supported. Speculation that the DAT group might report less depression due to loss of insight was not supported in this group of mildly to moderately demented patients. Only 22% demonstrated loss of insight, while 93% exhibited some degree of depressed mood on the HRS-D. Over 50% of the control group of PD spouses and community volunteers endorsed some degree of fatigue, work inhibition, and decreased libido, illustrating the need for considering base-rates in assessment.
Type:
text; Dissertation-Reproduction (electronic)
Keywords:
Depression, Mental.; Depression in old age.
Degree Name:
Ph.D.
Degree Level:
doctoral
Degree Program:
Psychology; Graduate College
Degree Grantor:
University of Arizona
Advisor:
Kaszniak, Alfred

Full metadata record

DC FieldValue Language
dc.language.isoenen_US
dc.titleCharacteristics of depression in neurologically impaired and normal elderly.en_US
dc.creatorDowner, Patricia.en_US
dc.contributor.authorDowner, Patricia.en_US
dc.date.issued1989en_US
dc.publisherThe University of Arizona.en_US
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en_US
dc.description.abstractSeverity and pattern of depressive symptomatology were examined among four groups of elderly individuals, i.e., patients with DSM-III diagnoses of major depression (n = 54), patients with presumed dementia of the Alzheimer's type (DAT) (n = 27), patients with idiopathic Parkinson's disease (PD) (n = 30), and normal controls (n = 29). The depressed elderly group obtained significantly (p < .001) higher means, and the control group obtained significantly (p < .01) lower means, than the neurologically impaired groups on clinician ratings (Hamilton Rating Scale for Depression, HRS-D) and self-report (Beck Depression Inventory, BDI) of depression. However, HRS-D means of the PD and DAT groups did not differ significantly (p < .125). The depressed elderly group also obtained significantly (p < .001) higher means than the contrast groups on HRS-D vegetative and cognitive depression primary factors (adapted from Rhoades & Overall, 1983), while the control group obtained significantly (p < .001 to 0.01) lower means. At the intermediate level, the PD mean on the vegetative factor was significantly (p < .05) higher than the DAT mean, while the groups did not differ significantly (p < .79) on the cognitive factor. The depressed elderly group obtained a substantially lower interfactor correlation coefficient than the neurologically impaired groups, suggesting greater heterogeneity in manifestation of depression at moderate than at mild levels of severity. However, the finding of zero variance on some HRS-D items for the neurologically impaired groups suggested that factor structures may differ for PD, DAT, and depressed groups. For PD patients, the prediction that PD symptom severity ratings would correlate more highly with clinician ratings (HRS-D) than self-report (BDI) of depression, due to PD symptoms that resemble depression, was not supported. Speculation that the DAT group might report less depression due to loss of insight was not supported in this group of mildly to moderately demented patients. Only 22% demonstrated loss of insight, while 93% exhibited some degree of depressed mood on the HRS-D. Over 50% of the control group of PD spouses and community volunteers endorsed some degree of fatigue, work inhibition, and decreased libido, illustrating the need for considering base-rates in assessment.en_US
dc.typetexten_US
dc.typeDissertation-Reproduction (electronic)en_US
dc.subjectDepression, Mental.en_US
dc.subjectDepression in old age.en_US
thesis.degree.namePh.D.en_US
thesis.degree.leveldoctoralen_US
thesis.degree.disciplinePsychologyen_US
thesis.degree.disciplineGraduate Collegeen_US
thesis.degree.grantorUniversity of Arizonaen_US
dc.contributor.advisorKaszniak, Alfreden_US
dc.contributor.committeememberAllender, Jamesen_US
dc.contributor.committeememberBootzin, Richarden_US
dc.contributor.committeememberYost, Elizabethen_US
dc.contributor.committeememberIttelson, Williamen_US
dc.identifier.proquest9004968en_US
dc.identifier.oclc703272630en_US
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