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The Relationship Between Patient, Informant, Social Worker, and Consensus Diagnoses of Personality Disorder in Elderly Depressed Inpatients

Received June 7, 1996; revised January 24, 1997; accepted September 3, 1997. From the Houston Veterans Affairs Medical Center, Baylor College of Medicine; Houston, Texas. Address correspondence to Dr. Molinari, Director, Geropsychology, Houston Veterans Affairs Medical Center, Psychology Service 116B, 2002 Holcombe Blvd., Houston, TX 77030.

Two psychiatrists simultaneously administered the Personality Assessment Form (PAF) to 20 depressed geropsychiatric inpatients and to 20 of their relatives (informants). A social worker also completed PAF ratings, and a consensus conference independently assigned an Axis II diagnosis. For patient interviews, categorical and dimensional interrater reliability indices for cluster and total personality disorders (PDs) were generally marginal. For informant interviews, categorical interrater reliability indices for cluster and total PDs were also marginal, but dimensional reliability was high. Consistent with previous research, agreement between categorical scores yielded by the four assessment methods was poor, but agreement between dimensional scores was generally better. It appears that patients, family members, and staff maintain different perspectives on patients' personality that, if overlapping, may provide useful diagnostic data.

Key Words: Geriatric Depression • Personality Disorder • Consensus Diagnosis

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