Abstract
Purpose :
To investigate the causality between mental health and dry eye through the relationship between childhood trauma and dry eye disease (DED) in adult life in a large population-based setting.
Methods :
DED was assessed using the validated Women’s Health Study questionnaire (either a clinical diagnosis of dry eye or highly symptomatic dry eye). Childhood trauma was assessed with the Childhood Trauma Questionnaire, yielding the domains physical abuse, physical neglect, emotional abuse, emotional neglect, and sexual maltreatment. Validated cut-offs were applied to create dichotomous outcomes in all domains. The relationship between childhood trauma and DED in adult life was assessed with logistic regression models, corrected for age, sex, income, education, smoking, BMI, a set of seven mental health disorders including anxiety and depression, and a set of 44 other comorbidities associated with DED.
Results :
DED was present in 9.3% of participants: 8.8% had a previous clinical diagnosis of dry eye and 2.0% had highly symptomatic dry eye. As shown in Table 1, subjects reporting any domain of childhood trauma had higher odds of having DED, corrected for age, sex, income, education, smoking and BMI. These relationships were much stronger for highly symptomatic dry eye than for a diagnosis of dry eye, but all were significant (data not shown). A substantial part of the increased odds was mediated through mental health disorders in adult life, and to a lesser extent through other comorbidities.
Conclusions :
A history of childhood trauma was associated with an increased risk of DED in adult life, particularly of dry eye symptomatology. We found evidence that this impact is partly mediated through increased mental health disorders in adult life, such as anxiety disorder and depression. These results add to the evidence that mental health is affecting dry eye.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.