Prevalence of depressive symptoms and associated factors in an urban, ophthalmic population

Abstract

Objective: To determine the prevalence of depressive symptoms in an adult ophthalmic patient population and to delineate correlates. Design: Cross-sectional study. Participants: Adult patients (⩾18 years) were approached in general and sub-specialty cornea, retina, and glaucoma ophthalmic clinics. A total of 367 patients from the four clinics were enrolled. Methods: Depressive symptoms were assessed using the Patient Health Questionnaire-9. A cut-off score of ⩾10 was used to indicate clinically significant depressive symptoms. Patient Health Questionnaire-9 scores were used to evaluate bivariate relationships between depressive symptoms and distance visual acuity, ocular diagnosis, diabetes status, smoking status, demographic information, and medications. Results: The majority of patients were female (52.9%) and Caucasian (48.6%). The mean age was 52.0 years (standard deviation: 16.7). Clinically significant depressive symptoms were present in 19.9% of patients overall; this rate varied slightly by clinic. Patients with low vision and blindness (visual acuity worse than 20/60) were more likely to have depressive symptoms (odds ratio = 2.82; 95% confidence interval: 1.90–4.21). Smoking and diabetes were also associated with depressive symptoms (odds ratio = 3.11 (2.66–3.64) and 3.42 (1.90–6.16), respectively). Conclusion: In a sample of urban ophthalmic adult patients, depressive symptoms were highly associated with low vision, smoking, and diabetes. This information can be used to target interventions to those at greatest risk of depressive symptoms.

<p>Visual Impairment and Mental Health: Unmet Needs and Treatment Options</p>

“…4,5,31 Besides high rates of physical comorbidity, people with visual impairments are at risk for poor mental health outcomes. [9][10][11] Importantly, approximately 68% of vision impairment is avoidable. 167 While blindness as a result of age-related disease (eg, AMD, diabetic retinopathy, glaucoma) is not reversible at this point, many impairments can be corrected or altogether avoided 131 with better attention to eye health, and doing so should prevent development of some mental health problems.…”

“…A sizable body of literature suggests that people with vision impairment are at increased risk for specific mental health problems. In particular, a number of studies have demonstrated a link between vision impairment and depression (eg, [9][10][11] ). Nearly one third of individuals with visual impairments and disabling eye diseases experience mild depressive symptoms, 12 while 10.7-45.2% of study samples report clinically significant (ie, moderate-to-severe) depressive symptoms.…”

“…Nearly one third of individuals with visual impairments and disabling eye diseases experience mild depressive symptoms, 12 while 10.7-45.2% of study samples report clinically significant (ie, moderate-to-severe) depressive symptoms. [10][11][12][13][14] In one study of adults aged 20 and older, 10.7% of individuals with visual acuity impairment (ie, worse than 20/40, but not including complete blindness) endorsed clinically significant levels of depression, as opposed to 6.8% of people without acuity impairment. 11 In a study of adults with more severe visual impairment (acuity worse than 20/60 or blindness), 45.2% of the sample reported moderate depressive symptoms as compared to 16.6% in the normal to near-normal vision group.…”

“…11 In a study of adults with more severe visual impairment (acuity worse than 20/60 or blindness), 45.2% of the sample reported moderate depressive symptoms as compared to 16.6% in the normal to near-normal vision group. 10 Additionally, data from community samples indicates that people with low vision and/or blindness are 1.6-2.8-times more likely to develop depression compared to those without vision impairment, 10,11 even after controlling for demographic variables (but not after accounting for socioeconomic and health characteristics 11 ). However, visual impairment has been shown to increase the risk of depression (hazard ratio=1.22), even after adjusting for demographic, socioeconomic, and health factors.…”

“…Vision loss affects all aspects of one's life. The findings reviewed indicate that mental health problems are a significant burden for many people with vision impairment., [9][10][11] However, despite the widespread prevalence of these issues, screening and treatment remain inadequate. Better outcomes may be achieved if several changes are made.…”