September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Depression in patients with and without Sjögren's syndrome from the Sjögren's International Collaborative Clinical Alliance
Author Affiliations & Notes
  • John Alexander Gonzales
    Ophthalmology, F.I. Proctor Foundation, San Francisco, California, United States
    Ophthalmology, University of California, San Francisco, San Francisco, California, United States
  • Jennifer Rose-Nussbaumer
    Ophthalmology, F.I. Proctor Foundation, San Francisco, California, United States
    Ophthalmology, University of California, San Francisco, San Francisco, California, United States
  • Vatinee Y. Bunya
    Ophthalmology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Caroline Shiboski
    Orofacial Sciences, University of California, San Francisco, San Francisco, California, United States
  • Tom Lietman
    Ophthalmology, F.I. Proctor Foundation, San Francisco, California, United States
    Ophthalmology, University of California, San Francisco, San Francisco, California, United States
  • Footnotes
    Commercial Relationships   John Gonzales, None; Jennifer Rose-Nussbaumer, None; Vatinee Bunya, None; Caroline Shiboski, None; Tom Lietman, None
  • Footnotes
    Support  National Eye Institute
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 6215. doi:
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      John Alexander Gonzales, Jennifer Rose-Nussbaumer, Vatinee Y. Bunya, Caroline Shiboski, Tom Lietman; Depression in patients with and without Sjögren's syndrome from the Sjögren's International Collaborative Clinical Alliance. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6215.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The Sjögren’s International Collaborative Collective (SICCA) is an NIH- and NEI-funded multicenter prospective cohort study exploring the etiology, diagnosis and treatment of Sjögren’s syndrome (SS). Depression has been associated with primary SS as well as with chronic ocular diseases such as uveitis, macular degeneration, and glaucoma. In this study we evaluate whether or not an elevated ocular staining score (OSS) is associated with higher scores on depression screening.

Methods : Patients enrolled into the SICCA registry between 2004 and 2010 had assessment of American College of Rheumatology (ACR) SS criteria and depression using the Patient Health Questionnaire-9 (PHQ9) at baseline. The association between ACR criteria or ocular symptoms and depression was analyzed using the Cochrane-Armitage test for trend.

Results : Of 3,409 patients enrolled into the SICCA cohort, 1,578 (46%) met ACR criteria for SS while 1,831 (54%) did not. There was a statistically significant difference in the number of patients who indicated "no depression" in those with SS compared to those without SS (48% vs. 33%, p < 0.001). Additionally, we found a difference in the number of patients who indicated no depression in those with OSS ≥ 3 compared to those with an OSS < 3 (42% vs. 35%, p < 0.001) and in patients with a LSGB focus score ≥ 1 compared to those with a negative LSGB focus score (48% vs. 35%, p < 0.001). Stratifying by race, the association between LSGB focus score and depression as well as OSS and depression was only statistically significant for non-Caucasians. Patients who complained of light sensitivity, gritty/scratchy sensation, and burning/stinging “half or more the time” compared to “some/none of the time“ had statistically significantly higher scores of depression (all p < 0.001). There was a higher proportion of patients who “never use artificial tears” having “no depression” compared to those using artificial tears “≥10 times a day” (47% vs. 33%, p < 0.001).

Conclusions : Symptoms of ocular discomfort (light sensitivity, gritty/sandy sensation, and burning/stinging) were associated with higher depression scores. Interestingly, meeting ACR criteria for a diagnosis of SS was not associated with higher depression scores in our cohort. Depression in patients with ocular discomfort ascribed to dry eye deserves recognition.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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