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Eileen L Mayro, Ann P Murchison, Lisa A Hark, Yang Dai, Benjamin Leiby, Laura T Pizzi, Julia A Haller; Depression screening in an urban, ophthalmic office: prevalence and associated factors. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1369.
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Visual impairment can lead to decreased functional status, increased loneliness, and a reduction in quality of life, all correlates of depression. This study aimed to assess the prevalence of depression in an urban, eye clinic population and determine the demographic and clinical characteristics of patients who screened positive for depression.
This prospective, pilot study included 200 new, adult (at least 18 years old) patients from a single eye hospital: 100 from the general eye clinic and 100 from the retina clinic. Each patient was screened for depression using the Patient Health Questionnaire-9 (PHQ-9). Information captured from the electronic medical record (EMR) included: race/ethnicity, age, gender, ocular diagnoses, smoking status, diagnosis of diabetes, systemic medications, and visual acuity. Univariate analyses were conducted to assess the relationship between these factors and depression.
Patients in both clinics had similar demographics with respect to race, gender, and age. Overall, 72 (41%) were African American, 110 (55%) were female, and the mean age was 52.4 years. Across clinics, 38 patients (19%) screened positive for major depression, compared with the national prevalence of 16%. Of the 50 diabetic patients, 18 (36%) screened positive for major depression, compared with the national prevalence of approximately 30%. Retina patients with depression had worse visual acuity than those without depression (P=0.014). Eight patients (4%) reported suicidal ideation and were referred to psychological services for further evaluation.
Currently, few ophthalmologists integrate depression screening into their practices. However, given the high rate of depression and presence of suicidal ideation in this population, it is vital that eye care clinicians consider that their patients may be depressed. Additionally, depression may affect adherence to medication and attendance of recommended follow-up appointments, which could affect ocular outcomes. Given that retina clinic patients who screened positive for depression had worse visual acuity, there appears to be a relationship between vision loss and depression. This study determined factors associated with depression in an eye patient population and highlights the need for systems-level changes to identify and refer eye patients with depression.
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