Abstract
Methods:
Seventy-two patients with glaucoma, 72 patients with glaucoma suspect and 26 controls comprised the study population. Anxiety and depression was evaluated by hospital anxiety and depression scale (HADS) questionnaire. In this study, scores higher than 10 on the HADS-A and HADS-D were defined as anxiety and depression, respectively. The relationship be-tween HADS and mean deviation (MD) of visual field tests or visual acuity of the better eye was analyzed in glaucoma patients.
Results:
Three (11.5%) controls, 11 (15.3%) patients with glaucoma suspect, and 15 (20.8%) patients with glaucoma had anxiety. One (3.8%) control, 5 (6.9%) patients with glaucoma suspect, and 15 (20.8%) patients with glaucoma had depression. In glaucoma patients, the number of anxiety patients was higher in patients who had MD of less than -6 dB and the numbers of anxiety and depression patients were higher in patients who had visual acuity of lower than 20/40.
Conclusions:
The rate of depression in patients with glaucoma is higher than that of glaucoma suspect and controls. There is no significant difference between the three groups in rate of anxiety. Clinicians are advised to not only offer medical treatment but also should monitor for mood disturbances like anxiety and depression to ensure compliance and quality of life of patients.
References
1. Resnikoff S, Pascolini D, Etya'ale D, et al. Global data on visual impairment in the year 2002. Bull World Health Organ. 2004; 82:844–51.
2. Kim CS, Seong GJ, Lee NH, Song KC. Prevalence of primary open-angle glaucoma in central South Korea the Namil study. Ophthalmology. 2011; 118:1024–30.
3. Friedman S. Cardiac disease, anxiety, and sexual functioning. Am J Cardiol. 2000; 86((2A)):46F–50.
4. Majani G, Pierobon A, Giardini A, et al. Relationship between psy-chological profile and cardiological variables in chronic heart failure. The role of patient subjectivity. Eur Heart J. 1999; 20:1579–86.
5. Peyrot M, Rubin RR. Levels and risks of depression and anxiety symptomatology among diabetic adults. Diabetes Care. 1997; 20(5):85–90.
6. Sim MY, Yun KW, Kim HK, et al. Depressive symptoms and ways of coping of patients with diabetes mellitus: compared with rheu-matoid arthritis patients and healthy subjects. J Korean Neuropsy-chiatr Assoc. 2005; 44:591–6.
7. Bruce TO. Comorbid depression in rheumatoid arthritis: patho-physiology and clinical implications. Curr Psychiatry Rep. 2008; 10:258–64.
8. Richardson LP, Lozano P, Russo J, et al. Asthma symptom burden: relationship to asthma severity and anxiety and depression symptoms. Pediatrics. 2006; 118:1042–51.
9. Maurer J, Rebbapragada V, Borson S, et al. Anxiety and depression in COPD: current understanding, unanswered questions, and re-search needs. Chest. 2008; 134((4 Suppl)):43S–56.
10. Tastan S, Iyigun E, Bayer A, Acikel C. Anxiety, depression, and quality of life in Turkish patients with glaucoma. Psychol Rep. 2010; 106:343–57.
11. Jayawant SS, Bhosle MJ, Anderson RT, Balkrishnan R. Depressive symptomatology, medication persistence, and associated health-care costs in older adults with glaucoma. J Glaucoma. 2007; 16:513–20.
12. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983; 67:361–70.
13. Oh SM, Min KJ, Pard DB. A study on the standardization of the hospital anxiety and depression scale for Koreans. J Korean Neuropsychiatr Assoc. 1999; 38:289–96.
14. Mabuchi F, Yoshimura K, Kashiwagi K, et al. High prevalence of anxiety and depression in patients with primary open-angle glaucoma. J Glaucoma. 2008; 17:552–7.
15. Demailly P, Zoute C, Castro D. Personalities and chronic glaucoma. J Fr Ophtalmol. 1989; 12:595–601.
16. Hamelin N, Blatrix C, Brion F, et al. How patients react when glau-coma is diagnosed? J Fr Ophtalmol. 2002; 25:795–8.
17. Cumurcu T, Cumurcu BE, Celikel FC, Etikan I. Depression and anxiety in patients with pseudoexfoliative glaucoma. Gen Hosp Psychiatry. 2006; 28:509–15.
18. Wilson MR, Coleman AL, Yu F, et al. Depression in patients with glaucoma as measured by self-report surveys. Ophthalmology. 2002; 109:1018–22.
19. Erb C, Batra A, Lietz A, et al. Psychological characteristics of pa-tients with normal-tension glaucoma. Graefes Arch Clin Exp Ophthalmol. 1999; 237:753–7.
20. Mabuchi F, Yoshimura K, Kashiwagi K, et al. Risk factors for anxi-ety and depression in patients with glaucoma. Br J Ophthalmol. 2012; 96:821–5.
21. Cove-Smith JR, Kirk CA. CNS-related side-effects with metopro-lol and atenolol. Eur J Clin Pharmacol. 1985; 28(Suppl):69–72.
22. Avorn J, Everitt DE, Weiss S. Increased antidepressant use in pa-tients prescribed beta-blockers. JAMA. 1986; 255:357–60.
23. Kaiserman I, Kaiserman N, Elhayany A, Vinker S. Topical be-ta-blockers are not associated with an increased risk of treatment for depression. Ophthalmology. 2006; 113:1077–80.
24. Epstein DL, Grant WM. Carbonic anhydrase inhibitor side effects. Serum chemical analysis. Arch Ophthalmol. 1977; 95:1378–82.
Table 1.
Controls (n = 26) | Glaucoma suspect (n = 72) | ) Glaucoma (n = 72) | p-value | |
---|---|---|---|---|
Age (years) | 50.9 ± 9.6 | 49.6 ± 11.0 | 49.2 ± 10.6 | 0.768∗ |
Sex | ||||
Male | 10 (38.5) | 27 (37.5) | 35 (48.6) | 0.384† |
Female | 16 (61.5) | 45 (62.5) | 37 (51.4) | |
Education (years) | ||||
<10 | 16 (61.5) | 40 (55.6) | 51 (70.8) | 0.168† |
≥10 | 10 (38.5) | 32 (44.4) | 21 (29.2) | |
Monthly income | ||||
<2.500 thousand won | 16 (61.5) | 51 (70.8) | 49 (68.1) | 0.697† |
≥2.500 thousand won | 10 (38.5) | 21 (29.2) | 23 (31.9) | |
Marital state | ||||
Married/cohabiting | 21 (80.8) | 57 (79.1) | 54 (75.0) | 0.801† |
Divorce/separated/ not married | 5 (19.2) | 15 (20.9) | 18 (25.0) | |
Occupation | ||||
Yes | 17 (65.4) | 53 (73.6) | 60 (83.3) | 0.134† |
No | 9 (34.6) | 19 (26.4) | 12 (16.7) | |
Hypertension | ||||
Yes | 2 | 10 | 16 | 0.392‡ |
No | 24 | 62 | 56 | |
Diabetic mellitus | ||||
Yes | 3 | 10 | 5 | 0.186‡ |
No | 23 | 62 | 67 | |
Spherical equivalent | -0.87 ± 1.11 | -3.10 ± 3.78 | -2.53 ± 3.64 | 0.244∗ |
log MAR BCVA of better eye | 0.89 ± 0.16 | 0.85 ± 0.19 | 0.89 ± 0.26 | 0.402∗ |
Table 2.
Controls | Glaucoma suspect group | Glaucoma group | p-value | |
---|---|---|---|---|
HADS-anxiety average | 4.8 ± 3.8 | 5.9 ± 3.7 | 6.5 ± 4.1 | 0.328∗ |
HADS-anxiety ≥8 | 5/26 (19.2) | 22/72 (30.6) | 22/72 (30.6) | 0.522† |
HADS-anxiety ≥10 | 3/26 (11.5) | 11/72 (15.3) | 15/72 (20.8) | 0.535‡ |
HADS-depression average | 3.3 ± 3.7 | 4.4 ± 3.1 | 5.3 ± 4.1 | 0.172∗ |
HADS-depression ≥8 | 4/26 (15.4) | 12/72 (16.7) | 19/72 (26.4) | 0.282† |
HADS-depression ≥10 | 1/26 (3.8) | 5/72 (6.9) | 15/72 (20.8) | 0.021‡ |
Table 3.
Anxiety score | p-value | Anxiety prevalence | e p-value | ||
---|---|---|---|---|---|
Sex | Male | 6.7 ± 4.1 | 0.776∗ | 8/36 | 0.727† |
Female | 6.4 ± 4.2 | 7/37 | |||
Age (years) | <50 | 6.7 ± 4.4 | 0.753∗ | 7/34 | 0.961† |
≥50 | 6.4 ± 4.0 | 8/38 | |||
Education (years) | <10 | 6.9 ± 4.7 | 0.716∗ | 3/13 | 1.000‡ |
≥10 | 6.5 ± 4.0 | 12/59 | |||
Economy | <2.500 thousand won | 6.5 ± 4.6 | 0.870∗ | 13/51 | 0.203‡ |
≥2.500 thousand won | 6.7 ± 2.6 | 2/21 | |||
Marital status | Married/cohabiting | 6.2 ± 3.6 | 0.246∗ | 9/57 | 0.069‡ |
Divorce/separated/not married | 8.0 ± 5.6 | 6/15 |
Table 4.
Depression score | p-value | Depression prevalence | p-value | ||
---|---|---|---|---|---|
Sex | Male | 5.3 ± 4.1 | 0.947∗ | 6/36 | 0.418† |
Female | 5.4 ± 4.3 | 9/37 | |||
Age (years) | <50 | 5.1 ± 4.4 | 0.618∗ | 5/34 | 0.226† |
≥50 | 5.6 ± 4.0 | 10/38 | |||
Education | <10 | 5.4 ± 3.9 | 0.951∗ | 2/13 | 0.723‡ |
≥10 | 5.3 ± 4.2 | 13/59 | |||
Monthly income | <2.500 thousand won | 5.0 ± 4.2 | 0.411∗ | 9/51 | 0.346‡ |
≥2.500 thousand won | 6.0 ± 4.1 | 6/21 | |||
Marital status | Married | 5.1 ± 4.1 | 0.292∗ | 10/57 | 0.281‡ |
Divorce | 6.3 ± 4.5 | 5/15 |
Table 5.
Better MD eye | MD ≥ -6.0 dB (n = 42) | MD < -6.0 dB (n = 30) | p-value |
---|---|---|---|
HADS-anxiety average | 5.9 ± 3.7 | 6.5 ± 4.1 | 0.093* |
HADS-anxiety ≥8 | 11/42 (26.2) | 11/30 (36.7) | 0.438† |
HADS-anxiety ≥10 | 5/42 (11.9) | 10/30 (33.3) | 0.039† |
HADS-depression average | 5.5 ± 3.8 | 5.1 ± 4.6 | 0.699* |
HADS-depression ≥8 | 11/42 (26.2) | 8/30 (26.7) | 1.000† |
HADS-depression ≥10 | 8/42 (19.0) | 7/30 (23.3) | 0.777† |