Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire ST5 5BG, UK.
BMC Ophthalmol. 2014 Jun 12;14:78. doi: 10.1186/1471-2415-14-78.
Comorbid mental health problems have been shown to have an adverse effect on the quality of life of people with common eye disorders. This study aims to assess whether symptoms of anxiety and/or depression are more prevalent in people with age-related macular degeneration (AMD) than in people without this condition.
A systematic search of electronic databases (Medline, CINAHL, EMBASE, PsycINFO) from inception to February 2012 was conducted to identify studies of AMD populations which measured symptoms of anxiety and/or depression. Reference checking of relevant articles was also performed. Data on the study setting, prevalence and how anxiety and depression were measured were extracted from the papers. Critical appraisal was performed using the Critical Appraisal Skills Programme (CASP) tools.
A total of 16 papers were included in the review, from an original search result of 597. The prevalence estimates, taken from nine cross-sectional and cohort studies, ranged from 15.7%-44% for depressive symptoms and 9.6%-30.1% for anxiety symptoms in people with AMD. The seven case-control studies found that people with AMD were more likely to experience symptoms of depression compared with those without AMD, but not more likely to experience symptoms of anxiety.
Overall, the evidence suggests that symptoms of depression are more prevalent amongst AMD populations than anxiety symptoms. The heterogeneity of the studies included in this review means that it is difficult to draw strong conclusions as to the true estimates of depression and anxiety symptoms in AMD populations and prevented formal meta-analysis. Further research which specifies clinical anxiety and gives clear definitions as to the type of AMD being investigated is required.
合并的心理健康问题已被证明对患有常见眼部疾病的人的生活质量有不利影响。本研究旨在评估年龄相关性黄斑变性（AMD）患者的焦虑和/或抑郁症状是否比没有这种情况的患者更为普遍。
对从开始到 2012 年 2 月的电子数据库（Medline、CINAHL、EMBASE、PsycINFO）进行了系统检索，以确定评估 AMD 人群中焦虑和/或抑郁症状的研究。还对相关文章进行了参考文献检查。从论文中提取了关于研究背景、患病率以及如何测量焦虑和抑郁的信息。使用关键评估技能计划（CASP）工具进行了关键评估。
综述共纳入 16 篇论文，最初检索结果为 597 篇。从九项横断面和队列研究中得出的抑郁症状患病率估计值在 AMD 患者中为 15.7%-44%，焦虑症状为 9.6%-30.1%。七项病例对照研究发现，AMD 患者比没有 AMD 的患者更有可能出现抑郁症状，但不太可能出现焦虑症状。
总体而言，有证据表明 AMD 人群中抑郁症状比焦虑症状更为普遍。本综述中纳入的研究存在异质性，因此很难就 AMD 人群中抑郁和焦虑症状的真实估计值得出强有力的结论，也无法进行正式的荟萃分析。需要进一步的研究来明确临床焦虑，并明确界定正在研究的 AMD 类型。
