Introduction: Vision is the most important sensorial part of the human information system. Visual loss leads to reduced ability to perform routine activities of daily living and can be a risk for stable mental health.
Aim: The aim of this cross-sectional study is to assess the incidence of depression in patients treated in an ophthalmological outpatient clinic. To our knowledge this is the first study of its kind in our country.
Subjects and method: The number of evaluated patients was a hundred; mean age 41.6 ± 15.9 years, with different educational levels and common ophthalmological disorders. For the assessment of the level of depression the Beck Depression Inventory was used. Patients were divided into two groups: serious ophthalmological diagnoses where we expected psychological problems (N = 65) and the simplest ones (N = 35) as a control.
Results: Obtained results show that the levels of depression correlate with the diagnoses. Patients in the first group (serious ophthalmological diagnoses) showed moderate depression in 12% and severe in 13% of patients. It was shown that the most depressed were the patients suffering from age-related macular degeneration and proliferative diabetic retinopathy, as well as glaucoma and cataract. The second group showed BDI scores of normal values. The level of depression is positively correlated with age and the level of education (p < 0.05).
Conclusion: Depression is an important mental problem in ophthalmological practice. It is usually unrecognized and untreated. Depression could be the risk factor for treatment and prognosis of eyes diseases. Some measures for mitigation of psychological problems are proposed.
If the inline PDF is not rendering correctly, you can download the PDF file here.
1. Steer RA, Ball R, Ranieri WF, Beck AT. Dimen sions of the Beck Depression Inventory-II in clini cally depressed out pa tients. J Clin Psychol. 1999; 55(1): 117–128.
2. Steer RA, Cavalieri TA, Leonard DM, Beck AT. Use of the Beck Depression Inventory for Primary care to screen for major depression disorders. Gen Hosp Psych. 1999; 21(2): 106–111.
3. Brody BL, Gamst AC, Williams RA, Smith AR, Lau PW, Dolnak D, Rapaport MH, Kaplan RM, Brown SI. Depression, visual acuity, comorbidity, and disability associated with age-related macular degeneration. Ophthalmology. 2001; 108 (10): 1893–900.
4. Zhang X, Bullard KM, Cotch MF, Wilson MR, Rovner BW, McGwin G, Owsley C, Barker L, Crews JE, Saaddine JB. Association Between Depression and Functional Vision Loss in Persons 20 Years of Age or Older in the United States, NHANES 2005– 2008, JAMA Ophthalmol. 2013; 131(5): 573–581.
5. Lee AG, Beaver HA, Jogerst G, Daly JM. Screening elderly patients in an outpatient ophthalmology clinic for dementia, depression, and functional impairment. Ophthalmology. 2003; 110(4): 651–7.
6. Yochim BP, Mueller AE, Kane KD, Kahook MY. Prevalence of cognitive impairment, depression, and anxiety symptoms among older adults with glau coma. J Glaucoma. 2012 Apr-May; 21(4): 250–4.
7. Jivraj J, Jivraj I, Tennant M, Rudnisky C. Prevalence and impact of depressive symptoms in patients with age-related macular degeneration. Can J Ophthalmol. 2013 Aug; 48(4): 269–73. doi: 10.1016/j.jcjo.2013.03.007
8. Yuzawa M, Fujita K, Tanaka E, Wang EC. Assessing quality of life in the treatment of patients with agerelated macular degeneration: clinical research fin dings and recommendations for clinical practice. Clin Ophthalmol. 2013; 7: 1325–32. doi: 10.2147/OPTH.S45248. Epub 2013 Jul 1
9. Jivraj J, Jivraj I, Tennant M, Rudnisky C. Prevalence and impact of depressive symptoms in patients with age-related macular degeneration. Can J Ophthalmol. 2013 Aug; 48(4): 269–73. doi: 10.1016/j.jcjo.2013.03.007
10. Yuzawa M, Fujita K, Tanaka E, Wang EC. Assessing quality of life in the treatment of patients with agerelated macular degeneration: clinical research findings and recommendations for clinical practice. Clin Ophthalmol. 2013; 7: 1325–32. doi: 10.2147/OPTH.S45248. Epub 2013 Jul 1
11. Mitchell J, Bradley C. Quality of life in age-related macular degeneration: a review of the literature. Klin Monbl Augenheilkd. 2010 Aug; 227(8): 646–52.
12. Meyer-Ruesenberg B, Richard G. [New insights into the underestimated impairment of quality of life in age-related macular degeneration – a review of the li terature]. Klin Monbl Augenheilkd. 2010 Aug; 227(8): 646–52.
13. Mitsuko Yuzawa, Kyoko Fujita, Erika Tanaka, and Edward C Y Wang Assessing quality of life in the treatment of patients with age-related macular dege neration: clinical research findings and recommenda tions for clinical practice. Clin Ophthalmol. 2013; 7: 1325–1332.
14. Labbé A, Wang YX, Jie Y, Baudouin C, Jonas JB, Xu L. Dry eye disease, dry eye symptoms and depression: the Beijing Eye Study. Br J Ophthalmol. 2013 Nov; 97(11): 1399–403. doi: 10.1136/bjophthalmol-2013–303838. Epub 2013 Sep 7.
15. Maca SM, Wagner J, Weingessel B, Vécsei-Marlovits PV, Gruber K, Schiesser AW. Acute anterior uveitis is associated with depression and reduction of general health. Br J Ophthalmol. 2013 Mar; 97(3): 333–7. doi: 10.1136/bjophthalmol-2012-302304. Epub 2013 Jan 19
16. Zhou C, Qian S, Wu P, Qiu C. Quality of life of glau coma patients in China: sociodemographic, clinical, and psychological correlates-a cross-sectional study. Qual Life Res. 2013 Sep 24. [Epub ahead of print]
17. Zhou C, Qian S, Wu P, Qiu C. Anxiety and depresssion in Chinese patients with glaucoma: sociodemographic, clinical, and self-reported correlates. J Psychosom Res. 2013 Jul; 75(1): 75–82. doi 10.1016/j.jpsychores.2013.03.005. Epub 2013 Apr 11
18. Wang SY, Singh K, Lin SC. Prevalence and pre dictors of depression among participants with glauco ma in a nationally representative population sample. Am J Ophthalmol. 2012 Sep; 154(3): 436–444.e2. doi: 10.1016/j.ajo.2012.03.039. Epub 2012 Jul 11
19. Yokoi T, Moriyama M, Hayashi K, Shimada N, Tomita M, Yamamoto N, Nishikawa T, Ohno-Matsui K. Predictive factors for comorbid psychiatric di– sorders and their impact on vision-related quality of life in patients with high myopia. Int Ophthalmol. 2013 Jun 21. [Epub ahead of print].
20. Mozaffarieh M, Sacu S, Benesch T, Wedrich A. Mental health measures of anxiety and depression in patients with retinal detachment. Clin Pract Epide– miol Ment Health. 2007 Jul 19; 3: 10.
21. Caceres V. Managing fear and depression in glau– coma patients, GLAUCOMA, 2013, BioMed Central Ltd. Open Access
22. Caceres V. Minimal depression can affect AMD patients' visual function, OPHTHALMOLOGY NEWS, 2007, BioMed Central Ltd. Open Access.