In Reply to Drinka and Drinka

Abstract

To the Editor: — In their letter, Dr Drinka and Ms Drinka question the generalizability of research findings using a sample of normal elderly volunteers from a senior citizens’ center, suggesting that these subjects are atypical of the geriatric population at large. The authors imply that elderly volunteers are a self-selected group characterized by positive attitudes which they feel are not “normal.” We agree that this psychiatrically healthy group tended to consist of likeable, gregarious, and well-adjusted individuals who regarded research projects without suspicion. Are these attitudes normal? Actually, little is known about what constitutes mental health in the elderly, and there is no reason to assume that adaptive personality traits are infrequently found. We have certainly encountered an excessively positive, seemingly unrealistic “have a nice day” attitude, especially in senior citizens’ centers and other nonhospital settings. Such behavior may be characteristic of a group of elderly individuals who have not had major affective illness earlier in life. By process of selection this group may also be unusually free of personality dysfunction, consistent with the hypothesis that personality disorders predispose to affective illness or represent subclinical affective symptomatology. Alternatively, the strongly positive attitudes observed in elderly volunteers might reflect a particular constellation of personality traits unique to healthy old age. This is an important area for future developmental studies in geriatric psychiatry. Dr Drinka and Ms Drinka also suggest that the patient group in our study was not representative of geriatric depression. Because patients recovered from less severe depression (ie, outpatients) may not have had the same disorder as those requiring admission, we limited this study to a comparison of hospitalized major depressives and normal controls. Further investigations of personality traits in depressed geriatric outpatients would be of considerable interest.