Purpose:
To investigate the prevalence of dry eye disease (DED) and risk factors among patients with psychiatric disorders.
Methods:
A cross-sectional survey was conducted at the psychiatric clinics of Shanghai Mental Health Center,China.Subjects completed OSDI(Ocular Surface Disease Index),SAS(The Zung Self-Rating Anxiety Scale),SDS(The Zung Self-Rating Depression Scale).Participant characteristics,dry eye symptoms, psychiatric variables such as type and course of psychiatric disorders;duration and subtype of antidepressant medications; other risk factors were evaluated.Dry eye symptoms conbined with Schirmer’s test,tear break-up time as standard of DED diagnosis.Patients who met the following criteria (1) and (2),or (1) and (3) were diagnosed as DED:(1)any of dry eye symptoms;(2)BUT<10s and ST<10mm/5min;(3)BUT<5s or ST< 5mm/5min.
Results:
170 patients (36.0%) with generaliaed anxiety disorder,11 patients (2.3%) with panic disorder, 55 patients (11.7%) with obesessive-compulsive disorder,176 patients (37.3%) with depression and 60 patients with anxiety and depression were enrolled.The prevalence of DED is 60.0% that higher than other surveys carried out in China.In logistic regression analysis, age(OR=1.251,P=0.0018), course of psychiatric disorders(OR=1.083,P=0.0030),selective serotonin reuptake inhibitors (SSRI,OR=1.551,P=0.0260) are independent risk factors for the presence of DED.Age(OR=1.207,P=0.0032),tricyclic antidepressants (OR=9.130,P=0.0073), SAS>52(OR=2.136, P=0.0009) are independent risk factors while SDS>48(OR=0.625,P=0.0073) is a protective factor for vision-associated quality of life.
Conclusions:
DED seems to be common ocular manifestation in patients with psychistric disorders,especially with SSRI.Mood status may influence the truth of vision-related function.We conclude psychiatric disorders and SSRI-taking should be included in the differential diagnosis of DED.In addition,attention should be pay to the psychiatric factors in evaluating dry eye effects on vision-related quality of life.
Keywords: cornea: tears/tear film/dry eye • clinical (human) or epidemiologic studies: prevalence/incidence • clinical (human) or epidemiologic studies: risk factor assessment