Psychosomatic aspects in patients with central serous chorioretinopathy

Abstract

Aims: Patients with central serous chorioretinopathy were tested for psychosomatic symptoms and social support at the onset of their ailments; their personality profiles were also tested. Methods: 24 consecutive outpatients at the department of ophthalmology, Freiburg University Hospital, Freiburg, Germany, presenting with central serous chorioretinopathy filled in the following standardised questionnaires: Symptom Checklist 90-R (SCL 90-R), Symptom List, Questionnaire on Social Support, and Sixteen Personality Factor Questionnaire. Results: The sample (n=24) included 22 male patients with an average age of 44.1 years. Three quarters of the patients have children and live with their families; three quarters are white collar workers or self employed; one quarter are skilled blue collar workers. 12 patients were suffering from the ailment for the first time; 12 patients were undergoing a relapse. Mean visus of the affected eye was 0.8. The Symptom List yielded an inconspicuous total score for psychosomatic symptoms. In the SCL 90-R, nine out of 24 patients (37%) evinced elevated psychic stress. The total value of the questionnaire on social support showed good social support. In the Sixteen Personality Factor Questionnaire, the patients showed heightened emotional instability and insecurity as well as flexibility and spontaneity. Conclusion: The sociodemographic data confirm that central serous chorioretinopathy is predominantly an ailment of middle aged, socially well integrated men. This study suggests elevated psychic stress a few weeks after the onset of the ailment. The personality factors in the patients with central serous chorioretinopathy found in this study have to be verified with other populations. These results did not clearly show that psychosocial factors have a definite role in the aetiology of central serous chorioretinopathy. In order to make any clear assertions about this matter, further longitudinal studies on the progression of psychosocial parameters with larger patient samples would be indispensable. Since the original description of central serous chorioretinopathy (CSC) by von Graefe in 1866, 1 a variety of aetiological factors and pathophysiological mechanisms have been discussed. 2 The aetiology of CSC remains unclear to this day.3 Psychosomatic aspects of the ailment were pointed out long ago. 4 Harrington 5 and Zeligs 6 reported a relatively high incidence of CSC among American naval personnel during the second world war. It was suggested that anxiety and acute psychological trauma have a definite role in precipitating the ocular disorder. [5][6][7][8] In subsequent studies, it was shown that a high proportion of those suffering from CSC are young men. 5-10In the 1970s, Werry and Arends 11 described a neurotic personality structure in patients with CSC which could not, however, be confirmed by later studies.12 13 A further study associated CSC with type A behaviour.10 Contradictory evidence has also been gathered regarding the number of life events before the onset of CSC. 12 14-16 I...

Psychological Distress and Poor Quality of Life in Patients with Central Serous Chorioretinopathy

“…It is a 90-item multidimensional questionnaire used to screen for a broad range of psychological problems. Each of the 90 items is rated on a five-point Likert scale of distress, ranging from ''not at all'' (0) to ''extremely'' (4). Subsequently, the answers are combined in the 10 primary symptom dimensions: somatization, obsessive-compulsiveness, interpersonal sensitivity, depression, anxiety, angerhostility, phobic anxiety, paranoid ideation, psychotism, and others.…”

Central Serous Chorioretinopathy

“…People referred to as having a type A personality are usually characterized by a highly status-conscious, ambitious and rigidly organized pattern of behavior [57]. Further risk factors that have been proposed include pregnancy, alcohol consumption, untreated hypertension, use of antibiotics, bone marrow or organ transplantation, infection of the respiratory tract and infection with Helicobacter pylori [12,44,58,59,60,61,62,63]. …”

Effect of Stress on Central Serous Chorioretinopathy& Correlation with type of leak on FFA

“…Wang et al [1] , Spahn et al [14] and Conrad et al [15] noted that patients with poor coping mechanisms when exposed to a stressful situation like divorce, critical illness developed CSCR. Gelber et al [17] found that acute stressors preceded the onset of CSCR by a week.…”

“…[12,13] CSCR has been associated with severe psychosocial stressors. [14,15] Thomas Holmes and Richard Rahe in 1967 designed Social Readjustment Rating Score based on 43 life events to study if stress contributes to an illness. [16] Rather than taking an unstructured history they thought it is better to have a list of commonly involved stressors which ranged from death of spouse to change in sleep pattern.…”