Prevalence of Anxiety and Depression in Patients With Primary Glaucoma in Western India

Abstract

Précis: Glaucoma can cause disturbance in psychological and emotional functioning of patients, leading to anxiety and depression, even early in the disease. Identification and management of these problems should be included as a part of the holistic approach for patient care.Purpose: The purpose of this study was to assess the prevalence of anxiety and depression in patients with primary glaucoma using a standard validated questionnaire.Methodology: A cross-sectional prevalence study was carried out on 200 patients attending the glaucoma outpatient clinic at a tertiary care eye hospital in Pune, India. After obtaining written consent, all patients underwent a thorough ophthalmic examination. Those with primary glaucoma were included in the study and classified on the basis of the Hodapp-Parrish-Anderson criteria. Participants were asked to respond to the Hospital Anxiety and Depression Scale (HADS) questionnaire, and responses were analyzed statistically. Results:The mean HADS-Anxiety score was 4.5 (SD = 3.4), while HADS-Depression was 4.1 (SD = 3.8). The severity of the disease was associated with significantly higher HADS scores. Mean HADS-Anxiety scores were 3.1 (SD = 2.9) for mild glaucoma, 4.4 (SD = 2.6) for moderate, and 7.7 (SD = 3.0) for advanced disease (P < 0.001). Similarly, mean HADS-Depression scores were 2.0 (SD = 2.6), 4.2 (SD = 3.0), and 8.3 (SD = 3.3), respectively for mild, moderate, and severe glaucoma (P < 0.001). Based on HADS scores, a third of patients (34.5%) were symptomatic for anxiety or depression, out of which 25 (12.5%) could be classified as definite cases. Duration of treatment had no association with HADS scores.Conclusions: An association exists between the amount of visual loss among patients with glaucoma and symptoms of anxiety and depression, irrespective of disease duration. This information may help to choose treatment approaches most likely to be beneficial to the patients.