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新诊断青光眼患者的抑郁及情绪指标

Depression and mood indicators in newly diagnosed glaucoma patients.

作者信息

Jampel Henry D, Frick Kevin D, Janz Nancy K, Wren Patricia A, Musch David C, Rimal Rajiv, Lichter Paul R

机构信息

Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.

出版信息

Am J Ophthalmol. 2007 Aug;144(2):238-244. doi: 10.1016/j.ajo.2007.04.048. Epub 2007 Jun 11.

Abstract

PURPOSE

To assess depression and mood indicators in subjects newly diagnosed with chronic open-angle glaucoma.

DESIGN

Cross-sectional study of data from a randomized clinical trial.

METHODS

Newly-diagnosed glaucoma patients enrolled in the Collaborative Initial Glaucoma Treatment Study (CIGTS) responded at baseline to quality-of-life (QOL) telephone interviews. We studied responses to the 33-item Visual Activities Questionnaire (VAQ), six items from a disease-specific Health Perceptions Index (HPI), and eight questions from the Center for Epidemiological Studies Depression Scale (CES-D). We correlated the responses to the HPI and the CES-D with visual acuity (VA) and CIGTS visual field (VF) as well as to the responses to the VAQ.

RESULTS

VAQ score was correlated (P < .01 in all cases) with better VA (P = -0.181), better VF (P = 0.139), worse VA (P = -0.128), and worse VF (P = .120). There were also correlations (P ranging from .24 to .38, all P values < or = .001) between patients' perception of their vision (total VAQ score) and each item on the HPI and CES-D. None of the clinical vision measures were associated with any of the CES-D items. The strongest correlation between a clinical measure and an item from the HPI was between worse VF and worry about the possibility of blindness (P = -0.114, P = .005). The odds ratio of reporting mood indicators and symptoms of depression increased with patients' perceptions of worsening visual function but not worsening VA or VF.

CONCLUSIONS

In these newly diagnosed glaucoma patients, symptoms of depression and altered mood were related to worse self-reported visual function as assessed by the VAQ, but not to monocular clinical measures of visual function.

摘要

目的

评估新诊断为慢性开角型青光眼患者的抑郁及情绪指标。

设计

对一项随机临床试验的数据进行横断面研究。

方法

参与协作性初始青光眼治疗研究(CIGTS)的新诊断青光眼患者在基线时对生活质量(QOL)电话访谈做出回应。我们研究了对33项视觉活动问卷(VAQ)、特定疾病健康认知指数(HPI)中的6项以及流行病学研究中心抑郁量表(CES-D)中的8个问题的回答。我们将HPI和CES-D的回答与视力(VA)、CIGTS视野(VF)以及VAQ的回答进行了关联分析。

结果

VAQ得分与更好的视力(P = -0.181)、更好的视野(P = 0.139)、更差的视力(P = -0.128)和更差的视野(P = 0.120)均相关(所有情况下P <.01)。患者对其视力的感知(VAQ总分)与HPI和CES-D上的每个项目之间也存在相关性(P值范围为.24至.38,所有P值≤.001)。没有任何临床视力测量指标与CES-D的任何项目相关。临床测量指标与HPI中的一个项目之间最强的相关性是更差的视野与对失明可能性的担忧之间(P = -0.114,P =.005)。报告情绪指标和抑郁症状的比值比随着患者对视觉功能恶化的感知而增加,但与视力或视野的恶化无关。

结论

在这些新诊断的青光眼患者中,抑郁症状和情绪改变与通过VAQ评估的更差的自我报告视觉功能相关,但与视觉功能的单眼临床测量指标无关。

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