The relationship between some personality traits and late life depression

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THE RELATIONSHIP BETWEEN SOME PERSONALITY TRAITS AND LATE LIFE DEPRESSION

Krsteska R., Batic D., Gorgevic A.

Аннотация

Вступление: Депрессия в пожилом возрасте является одним из наиболее часто встречающихся заболеваний среди пожилых людей, но она часто остается непризнанной. Возможное влияние личностных качеств человека на этиологию депрессии в пожилом возрасте уже давно представляет интерес для врачей. Предполагается, что некоторые особенности личности предрасполагают людей к развитию депрессии в пожилом возрасте.

Цель: Оценить влияние некоторых личностных качеств на развитие депрессии в пожилом возрасте.

Предмет и методы: Исследование проводилось по выборке из 120 участников: 60 пациентов с депрессией в пожилом возрасте и 60 пожилых людей, живущих в общине, без симптомов депрессии в возрасте 60+ лет. Все участники исследования отвечали на вопросы анкеты, созданной специально для целей исследования, по шкале гериатрической депрессии и международной классификации болезней десятого пересмотра.

Результаты: Более высокий процент депрессии обнаружен в группе пациентов, а не в контрольной группе в отношении трех личностных особенностей: низкая самооценка (Yateschi-square=24.99 df=1 p=0.00000), зависимость от другого человека (Yateschi-square=22.03 df=1 p=0.00000) и пессимизм (Yateschi-square=25.04 df=1 p=0.00000).

Вывод: Наше исследование показало наличие значительной связи между низкой самооценкой, зависимостью от другого человека, пессимизмом и депрессией в пожилом возрасте. Эти данные свидетельствуют о том, что риск депрессии в пожилом возрасте выше среди пожилых пациентов с этими личностными качествами.

Ключевые слова: личностные черты, депрессия в пожилом возрасте, пожилые люди.

Abstract

Introduction: Late-life depression is one of the most frequent disorders in elderly and often remains unrecognized. The possible influence of personality traits on the etiology of late-life depression has long been of interest to clinicians, often with the assumption that some personality features predispose individuals to develop depression in late life.

Objective: To estimate the impact of some personality traits on late-life depression.

Subjects and Methods: The research was conducted on a sample of 120 participants, 60 patients with late-life depression and 60 community-dwelling older adults without depressive symptoms, aged 60+. All participants were examined using a general questionnaire created for the purpose of the study, the Geriatric Depression Scale, and ICD-10.

Results: A higher percentage with statistical significance was found in the group of patient than in the control individuals, regarding the three personality features: Low self-esteem (Yates chi-square=24.99 df=1 p=0.00000), Dependent from other person (Yates chi-square=22.03 df=1 p=0.00000), and Pessimism (Yates chi-square=25.04 df=1 p=0.00000).

Conclusion: Our study has shown a significant positive relationship between low self-esteem, dependent from other person and pessimism with late life depression. These data suggest that late-life depression risk is elevated among elderly patients with these personality traits.

Keywords: personality traits, late-life depression, elderly.

Late-life depression is a disorder in many cases of elderly patients and unfortunately, it is generally not recognized. Numerous studies have explored the connection between personality traits and depression in aged people but from a different view. It is possible the long-standing personality traits to be the possible factor that favors the appearance of depression in advancing years, and to predict the onset of depressed state in the older people. Some studies have shown that low self-esteem, dependence from other person and pessimism are discussed as potential causes that are possibly liable for depression in the elderly [1], [2].

Objective

Our study objective was to inspect where there is an influence from the risk factors like low self-esteem, dependence from other person and pessimism to the risk of the occurrence of depression in older people.

Subject and Methods

Our examination was a cross-sectional study that used interviewer-administered surveys. 120 older people were included in the study, out of which 60 people were with a diagnosis of a depressed state. These 60 people represented the experimental group. The control group was 60 people who lived in community and depression was excluded before they entered the study. The experimental group was consisted of 45 female patients and 15 male patients, while the control group was composed of 42 women and 18 men. Between the two groups the proportion was with p>0.05, respectively it was insignificant. All participants were aged sixty and more, and the examinees from the two groups did not differ significantly in regard to the years, so the statistical difference was also insignificant with p=0.56. The two groups were homogenous groups about the gender and the age.

Data were taken from all examinees from both groups using a general query created for the needs of our study, and also all participants were examined with the Geriatric Depression Scale (GDS) and the criteria by the International Statistical Classification of Diseases and Related Health Problems 10^thRevision (ICD-10)-WHO. A significant difference of p<0.001 was found in the two groups in regard to their mean scores on the GDS.

Results with discussion

The professional literature suggests that low self-esteem is connected to depressed moods, depression, hopelessness, and tendencies with suicidal behavior and attempted suicide. The investigation showed a significant negative correlation between self-esteem and depressiveness [3].

Also in some studies, a correlation between optimism and depression, as well as among optimism and suicidal thinking was found [4].

In our research performed on participants from both the experimental and the control group, we explored the existence of the three personality traits of the experimental and the control group: low self-esteem, dependent from other person and pessimism, named like possible risk factors for depression in elderly people (Table 1).

Table 1 - The existence of the personality features low self-esteem, dependent from other person and pessimism in the two examined groups

1. Yates chi-square=24.99 df=1 p=0.00000**

Odds ratio=8.27 95%CL 3.31<OR<21.21

2. Yates chi-square=22.03 df=1 p=0.00000**

Odds ratio=7.5 95%CL 2.97<OR<19.38

3. Yates chi-square=25.04 df=1 p=0.00000**

Odds ratio=9.9 95%CL 3.58<OR<28.47

Table 1 displays the results of the existence of the personality features low self-esteem, dependent from other person and pessimism in the investigated groups.

Higher percentages were exposed in the experimental group, than in the control group in regards to the three personality features, with statistically significant difference.

67% of the examinees from the experimental group, likewise their family, held the opinion for the existence of low self-esteem against 18.3% of the participants in the control group (Yates chi-square=24.99 df=1 p=0.00000), thus the people with low self-esteem have 8.27 times significantly greater risk to develop a depression in elder ages matched to people who don't have this personality trait (Odds ratio=8.27 95%CL 3.31<OR<21.21).

The second investigated personal trait - dependent of other person was found in 60% v.v. 16% among the group with depressed patients and people without of depression (Yates chi-square=22.03 df=1 p=0.00000). Accordingly, individuals with this personal characteristic have 7.5 times significantly greater risk for depression in contrast with the people who weren't dependent on another person (Odds ratio=7.5 95%CL 2.97<OR<19.38).

Also, in our research the examinees from the experimental group had 34% v.v.11.67% in the examinees without depression from the second group about the existence of pessimism (Yates chi-square=25.04 df=1 p=0.00000), with 9.9 times significantly greater risk for depression in elderly ages compared to the individuals who didn't have pessimism like personal trait (Odds ratio=9.9 95%CL 3.58<OR<28.47).

Several investigations noted that optimism has a positive influence on the health, as well as the physical and mental wellness. The investigators revealed that pessimism was in relation with greater depressive symptoms and lower self-esteem indirectly through constraints beliefs [4].

Our study has proven the relationship of the three personality traits: low self-esteem, a dependence of other person and pessimism with depression in older ages. These personality characteristics were more common in the depressed patients against individuals without depression.

Pakriev et al. noted that the factors related with self-esteem in people who don't have depression raise the sensitivity of the people for depression (causal risk factors), and too, these factors in the patients with depression cause the episode of depression more severe (pathoplastic risk factors). If the physicians start to think more about the mention factors of personality like risk factors for depression, they can enhance identification of depression and/or identification of more serious episodes of depression [5].

We have done a detailed examination of these personality characteristics of the people in our investigation. A difference with high statistical significance between the experimental and the control group in relation to the number of the risk personality traits (p=0.00000) was detected (Table 2, Figure 1).

Table 2 - The number of the personality traits: Low self-esteem, Dependent on another person and Pessimism in the both examiner groups

Note: Mann-Whitney U=549.0 Z=6.57 p=0.00000**

depression elderly disorder pessimism

Fig. 1 - The percentages of the number of the personality traits (Low self-esteem, Dependent on another person and Pessimism) in the two examined groups

The finding in our study offers that the sum of the personal risk characteristics also is a risk for the manifestation of late-life depression. Respectively, the presence of two, or even three risk personality traits elevate the risk for depression in elderly people.

The gender differences in people with depression related to the personality traits were examined from a different view from several authors [6-11].

We have analyzed the existence of the personality risk traits among male and female individuals with depression in the elderly age. It was found that the male individuals with depression had significantly more low self-esteem, however about the dependent on another person and pessimism, we didn't find the difference with statistical significance among the male and female individuals with depression (Table 3).

Table 3 - The percentages of the existence of the personality traits between male and female patients in the experimental group

Note:

1. Yates chi-square=4.13 df=1 p=0.042*; OR=4.75 95% CL 3.75<OR<34.61

2. Yates chi-square=0.83 df=1 p=0.36

According to Pakriev [5], it is promising our findings for these risk factors to improve attention in physician for their older patients with the possibility these personality characteristics to predict the onset and do early detection of late-life depression.

Duberstein [2] said that the findings of their study suggest that long-standing personality traits can predict the onset of depression in elderly people. He underlines that even in older age, these traits can be the risk. He supposed that something in regard with aging helps take down the protective mechanisms that protect them from the appearance of depression.

Unfortunately, there are not enough studies about the relationship again personality traits and depression in the elderly people. Our findings give a small contribution to clarifying the risk factors for depression in older ages. Further, according to Duberstein, we think that more surveys are needed for understanding of relationships among personality, ages, and appearance of depression [2].

Conclusion

The findings in our research have shown a significant relationship between low self-esteem, dependence from other person and pessimism with late-life depression. Our data confirmed the role of the personality characteristics, such as low self-esteem, dependence on other people and pessimism, which are psychological factors of risk for occurrence of depression in elderly. These personality features predispose persons to develop depression in late life.

The awareness of these personal risk factors could improve attention in physician for their older patients with these personality characteristics to predict onset or do early detection of depression in this population.

Our investigation enhances the consideration of the factors which raise the risk of depression and could aid in the identification of people at risk.

With bigger awareness of these risk factors, the individuals that have a greater risk for depression could benefit a lot in the process of depression recognition. An opportunity would be opened for designing the best strategy to prevent the beginning of the depressive symptoms in older ages, to detect the depression on time and to find the most suitable treatment for the patients.

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