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Augustinus Laude, Tock Lim, Adrian Koh, Fulton Wong, Roy Tan, Leslie Lim; Does retinitis pigmentosa cause depression?. Invest. Ophthalmol. Vis. Sci. 2013;54(15):678.
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Retinitis pigmentosa (RP) is an inherited progressive retinal degenerative disease that can eventually lead to blindness. The anticipation of being blind and the impact of the actual disease process itself on the visual function can result in significant distress and lead to depression. Depression may often be under-treated due to stigma, ignorance or non-recognition. It is thus important to try to detect depression among people with RP, as depression can be treated, improving quality of life. This study aimed to determine if subjects with RP are associated with increased risk of depression.
Forty-four subjects were recruited collectively from a local RP support group, Tan Tock Seng Hospital and Camden Medical Centre. We used the Hospital Anxiety Depression Scale (HADS) and Mini-International Neuropsychiatric Interview (MINI) as they are both brief structured interviews that were easy to conduct with acceptably high validation and reliability scores. We also administered the Visual Function Questionnaire (VFQ) 25 to assess the impact of the subjects' affected visual function.
Using the HADS, 3 (6.8%) subjects were found to have depressive symptoms, of whom one subject (2.3%) was found to suffer from major depressive disorder as detected by the MINI. The mean VFQ score for the 44 subjects was 51.7 and all 3 subjects who experienced depressive symptoms had VFQ scores lower than the 30th percentile range. In our study, the rate of depression amongst RP subjects compares favourably with the prevalence of major depression in the Singapore population (of about 6%). One limitation of this study was the relatively small sample size, which could have given rise to the low rate of major depression. The 3 subjects who experienced depressive symptoms also scored relatively lower in the VFQ-25. This suggests that reduced visual function may be an important predisposing factor for depressive symptoms.
In our population of RP subjects, we did not find a higher risk of depression. Further studies are required to determine the risks factors for depression and the factors that may contribute to resilience amongst those who are not depressed.
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