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David C Musch, Leslie M Niziol, Brenda W Gillespie, Nancy K Janz; Trends and Predictors of Depression among Participants in the Collaborative Initial Glaucoma Treatment Study (CIGTS). Invest. Ophthalmol. Vis. Sci. 2017;58(8):3732.
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To explore prevalence and predictors of depression after glaucoma diagnosis.
607 newly diagnosed open-angle glaucoma patients participated in the CIGTS. The 8-item version of the Center for Epidemiologic Studies Depression Scale (CES-D) was administered by telephone to participants at the time of glaucoma diagnosis, at 3 months, and every 6 months post-treatment for up to 10 years. Three measures of depression evidenced during the previous 7 days were assessed, including an overall symptom score (sum of 8 symptoms weighted by frequency, 0-24), a dichotomous measure (symptom score ≥7), and number of depressive symptoms reported ≥1 day (0-8). Repeated measures multivariable logistic regression was used to investigate predictors of the probability of being depressed. Variables considered were time since diagnosis, demographics, clinical measures of the eye, treatment, and vision-related quality of life (VRQOL) measured by the Visual Activities Questionnaire (mean of 33 items, each scored 1-5).
At the time of their glaucoma diagnosis, CIGTS participants reported a mean symptom score of 2.2 (standard deviation, SD=3.8; range=0-21; median=0), and a mean of 1.3 depressive symptoms (SD=1.9, range=0-8, median=0). Prevalence of depression was 12.3% at baseline, decreased to 7.8% at 3 months post-treatment, 6.5% at 1 year, and 6.7% at 5 years (Figure 1). Factors associated with an increased probability of depression included younger age (odds ratio, OR=0.83 per 10 years, p=0.0093), gender (OR=1.49, female vs. male; p=0.0371), race vs. White (Black, OR=1.47, p=0.0368; Asian, OR=0.06, p=0.0026; Other race, OR=2.67, p=0.0010), and worse VRQOL (OR=2.45 for 1 unit increase, p<0.0001). Initial glaucoma treatment, marital status, season, treatment center, and clinical measures of the study eye were not significantly associated with depression (all p>0.05).
We observed elevated depression levels upon glaucoma diagnosis, with decreases within the subsequent year. Eye care providers should be sensitive to the potential impact of glaucoma diagnosis on their patients’ mental well-being, aware of other factors that increase the risk of depression, and be prepared to answer questions and provide resources to help patients deal with depressive symptomatology.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
Figure. Proportion of subjects with depression over time since glaucoma diagnosis, with 95% confidence intervals.
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