Abstract
Purpose:
To investigate the association between dry eye disease and depression in an adult population.
Methods:
The Beijing Eye Study is a population-based study in northern China which included subjects aged 40 or older. In 2006, a random sample consisting of 1957 subjects subjects had dry eye investigations including an interviewer-assisted questionnaire of dry eye symptoms, measurement of tear break-up time (TBUT), slit-lamp evaluation of corneal staining and meibomian gland dysfunction (MGD), and Schirmer’s test. Dry eye disease was defined as Schirmer’s test ≤ 5 mm and/or TBUT ≤ 10 seconds accompanied by complaints of dry eye symptoms. In 2011, depressive symptoms were evaluated using a Chinese version of the Zung self-rating depression scale (ZDS). Definite depression was defined as having a ZDS of 50 or higher. The association between dry eye disease and depression was evaluated using logistic linear analyses.
Results:
From the 2006 random sample, 1526 subjects had depressive symptoms evaluation (78%). In 2011, the mean age of the 1526 participants was 64.66 ± 9.47 years (50-91) and 900 were women (59%). Among them, 244 (16%) had dry eye disease and 142 (9.3%) had depression. The ZDS was significantly correlated to dry eye symptoms (r=0.097; P<0,0001) and TBUT (r=-0.059;P=0.021) but not with Schirmer’s test (r=-0.005; P=0.857), corneal staining (r=-0.014;P=0.581) and MGD (r=-0.038;P=0.134). The risk of definite depression was significantly associated with dry eye diagnosis (OR=1.608), dry eye symptoms (OR=1.853) and female sex (OR=2.58). Using multivariate regression analysis, the risk of depression remained significantly associated with dry eye symptoms and female sex.
Conclusions:
Depression is associated with dry eye disease and dry eye symptoms. Chronic dry eye symptoms may worsen depressive symptoms in a susceptible population.
Keywords: 463 clinical (human) or epidemiologic studies: prevalence/incidence •
486 cornea: tears/tear film/dry eye