Premorbid personality and behavioral symptoms in Alzheimer disease. Some cautions
M. E. Strauss, M. M. Lee and J. M. DiFilippo
Alzheimer Center, University Hospital of Cleveland, Ohio, USA. mes3@po.cwru.edu
OBJECTIVE: To evaluate the extent to which the previously reported
relationship between premorbid personality and psychopathological symptoms
after the onset of Alzheimer disease (AD) is due to the use of a single
informant for both personality and symptom information. DESIGN: Premorbid
personality descriptions of patients with AD were obtained from 2 sources,
primary caregivers and secondary informants, using the Personality
Assessment Schedule and NEO-PI-R Neuroticism Scale, respectively. All
information regarding depression and anxiety since the onset of AD was
obtained from primary caregivers using clinical interviews and the Cornell
Scale for Depression in Dementia. RESULTS: When data were obtained from the
same informant, significant relationships were found between premorbid
personality and both presence of depression and the severity of anxiety
symptoms. When data were obtained from 2 different informants, the only
significant relationship was between premorbid neuroticism and anxiety
severity. CONCLUSION: As in a previous report, there was a relationship
between premorbid personality and depressive symptoms in AD, but only when
personality and symptom information was obtained from the same informant.
On the other hand, there was a relationship between premorbid personality
and severity of anxiety symptoms both when personality and symptom
information came from different informants as well as from the same
informant. These data suggest that retrospective bias contributes to the
apparent consistency between premorbid personality and some aspects of
psychiatric symptoms in AD, specifically depression.
