Prevalence and risk factors of depressive disorders in an urban, ophthalmic population

Abstract

Purpose : Previous studies have established a correlation between vision problems and depression, however depression research in eye-care settings has been very limited. This observational study aims to determine the prevalence of depression in an ophthalmic patient population and to delineate correlates of depressive symptoms.

Methods : A prospective survey of 367 new, adult participants seen in general ophthalmology, cornea, glaucoma, or retina clinics in an urban eye hospital was performed from 8/4/14 to 2/15/16. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9) and a cut-score of ≥10 was used to indicate the presence of symptoms consistent with clinical depression. Distance acuity, ocular diagnosis, diabetes status, smoking status, demographic information, and medications were collected from participants’ medical charts. Association of demographic and clinical characteristics with clinic and presence of depressive symptoms was evaluated using two-sample t-tests, ANOVA, or chi-square tests. The prevalence of depression, and bivariate relationships between depressive symptoms and clinical and demographic factors are reported.

Results : A total of 367 participants were enrolled from 4 clinics. The majority (52.9%) of participants were female, 48.6% were white, and 42.2% were African American; the mean age was 52.0. Seventy-three participants (19.9%) had PHQ-9 scores of 10 or greater, indicative of moderate depressive symptoms. The rates of depression per clinic were 18% in general ophthalmology, 20% in cornea, 22% in glaucoma, and 20% in retina. All non-medication variables associated with presence of depressive symptoms in a univariable analysis at the p<0.20 level were entered into a multivariable logistic regression model. This included visual acuity, smoking status, and diabetes diagnosis. Participants with low vision (VA<20/60) and blindness were more likely to have depressive symptoms (OR=2.82; 95% CI: [1.92-4.21]). Smoking status and diabetes diagnosis were also associated with depressive symptoms (OR=3.11 [2.66-3.64] and 3.42 [1.90-6.16], respectively).

Conclusions : In urban, ophthalmic adult participants, depression was highly associated with low vision, smoking, and diabetes. Understanding risk factors for depression in patients visiting an ophthalmologist could allow for better detection of depression.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.