Relationship Between Dry Eye Disease and Emotional Disorder: The Mediating Effect of Health Anxiety

Abstract

ObjectiveThis study aims to investigate the relationship between dry eye disease (DED) and anxiety, as well as DED and depression. Additionally, the influence of health anxiety (HA) on this relationship was determined.MethodsA total of 206 patients with DED were recruited from Tianjin Medical University Eye Hospital clinic and surveyed using demographic questionnaires, the Ocular Surface Disease Index (OSDI), Hospital Anxiety and Depression Scale (HADS), and Short Health Anxiety Inventory (SHAI). Additionally, they were examined using Keratograph 5M and assessed for DED by corneal fluorescein staining. Regression analysis and the bootstrap method were used to investigate the influence of HA on the relationship between DED and emotional disorders.ResultsAmong the 206 patients with DED, 52 (25.24%) and 56 (27.18%) patients showed depression and anxiety, respectively. The OSDI score and HA were positively correlated with depression and anxiety (P < 0.01). The direct effects of OSDI on depression and anxiety were significant (95% confidence interval [CI]: 0.017–0.069; 0.008–0.060). Additionally, the bootstrap test showed significant mediating effects of HA (95% CI: 0.001–0.016; 0.003–0.021). The results suggested that the severity of DED symptoms, as measured by the OSDI score, affected anxiety and depression by a direct and an indirect pathway mediated by HA.ConclusionsWe found a significant correlation between DED and anxiety and depression. Moreover, HA was a mediator of the relationship between DED symptoms and anxiety and depression.

Prevalence of Dry Eye Symptoms and Associated Risk Factors among University Students in Poland

“…In this study, it was found that depression and other mental diseases were significantly associated with a greater risk of DES (OSDI: respectively, p < 0.001 and p = 0.019, DEQ-5: respectively, p = 0.005 and p = 0.127, which is close to significance), as well as increased severity of DES (OSDI: respectively, p < 0.001 and p = 0.039). These results are consistent with previous studies on the connection between DED and mental illnesses (including depression, anxiety, PTSD, dementia, bipolar disorder and neurotic disorders) [8,47,48] and also in the population of young adults [49,50]. Moreover, depression and anxiety were found to be more prevalent and their symptoms were significantly more severe in patients diagnosed with DED [51].…”

“…These symptoms can significantly impact patients' quality of life and lead to reduced work and learning efficiency [4,6]. Patients with DED also have a greater risk of suffering from mental health disorders such as depression and anxiety [7,8]. Despite this, many people with DED remain unevaluated, undiagnosed, and untreated, especially among the young population [9,10].…”

Depression and anxiety of medical students at Kunming Medical University during COVID-19: A cross-sectional survey

“…Individuals with familial Mediterranean fever ( 33 ), chronic pain ( 34 ), and an increased inflammatory response (augmentation of interleukin-6, C-reactive proteins, and fibrinogen blood levels) ( 35 ) will experience anxiety symptoms at higher rates than the general population. In addition, dry eye disease may lead to emotional disorders such as anxiety due to the long-term symptoms of eye irritation ( 36 ). In addition to the anxiety caused by the disease itself, worrying about its long course and its impact on the body may also cause anxiety.…”

Dry eye syndrome among students: A review

“…When compared to other eye diseases, dry eye patients are more likely to develop anxiety and depression. In addition, symptoms can impact the quality of life of these patients (He Q et al, 2022).…”