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R. J. Donati, D. M. Maino, H. Bartell, M. Kieffer; Reported Symptomology of Those With Mental Illness and Dual Diagnosis. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4479.
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Individuals with mental illness (MI) and dual diagnosis [MI and mental retardation (MR) DD] are known to have numerous systemic and oculo-visual anomalies. This co-morbidity of conditions should elicit frequent complaints from patients with MI and DD during the initial review of systems. This paper assessed the frequency of these symptoms within these unique populations.
A retrospective analysis of all medical records for patients (N=230) evaluated at the Neumann Association (NA) Developmental Disabilities Service of the Illinois Eye Institute was completed. Only records of patients with MI and Dual Diagnosis who were prescribed antipsychotics, antidepressants, anticonvulsants, and/or tranquilizers were used for our analysis. We determined the frequency of ocular anomalies, drugs taken and symptoms reported by patients during the initial review of systems.
Upon record review, 89.9% of MI and 60.2% of DD individuals met the above subject criteria. The most common side effects for the drug types mentioned were blurred vision (near or far), visual disturbances, decreased vision, dimming of vision, and light sensitivity/photophobia. The most frequently encountered symptoms were no complaints (45.2% MI and 46.3% DD), blurry vision (17.7% MI and 17.5% DD), need new glasses (11.3% MI and 18.8% DD), decreased vision (6.5% MI and 1.3% DD), red/itchy eyes (6.5% MI and 5.0% DD).
MI and DD populations exhibit a higher incidence of oculo-visual anomalies (uncorrected refractive error, binocular vision anomalies, ocular pathology) than noted in the general population. They are also typically taking one or more neuro-psychotropic medications that are frequently associated with undesirable side effects. Individuals with MI and DD therefore should report numerous symptoms associated with the medications they take and the oculo-visual anomalies they exhibit during the initial case history and review of systems. The data of this study suggests that this is not the case and that only about 50% of those who should have symptoms actually report them.
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