Liyue Hong, Chiang Peggy Pei-Chia, Sung Sharon C, Tong Louis
a Yong Loo Lin School of Medicine, National University of Singapore , Singapore , Singapore .
b Singapore Eye Research Institute , Singapore , Singapore .
Curr Eye Res. 2016 May;41(5):590-9. doi: 10.3109/02713683.2015.1056804. Epub 2015 Sep 4.
Dry eye is a common condition known to have many systemic co-morbidities. We aim to report the frequency of depression and anxiety suspects in eye clinic patients and explore the association between dry eye signs and symptoms with depression and anxiety.
Adult outpatients were recruited from dry a public tertiary ophthalmology specialist center. Participants underwent socio-demographic and dry eye symptoms questionnaires, fluorescein dye tear break-up time (TBUT), fluorescein dye corneal staining and Schirmer's test. Rasch analysis was used to internally validate the Hospital Anxiety and Depression Scale (HADS) and the Center for Epidemiologic Studies Depression Scale (CES-D) and determine its psychometric properties.
A total of 96 participants (mean age 54.5 ± 10.8; 64.1% women) were recruited. The mean score for the CES-D was 12.1 ± 9.8 with 28 participants (31.5%) having a score of above 16 (published threshold). The mean score for depression-associated questions in the HADS was 3.6 ± 3.6 with 13 participants (14.1%) having a score ≥8. The mean score for the anxiety-associated questions in the HADS was 5.3 ± 3.6 with 24 participants (26.1%) having score ≥8. There was a weak inverse correlation between Schirmer's test and CES-D scores. Elevated depression scores from the CES-D were significantly associated with visual blurring but not irritation, in dry eye patients with low TBUT.
In conclusion, specific types of dry eye symptoms, particularly those with increased frequency of visual blurring were associated with symptoms of depression. The optical aberrations induced by dry eye, associated with tear instability, may predispose to depressive tendency.
干眼症是一种常见病症，已知伴有多种全身性共病。我们旨在报告眼科门诊患者中疑似抑郁和焦虑的发生率，并探讨干眼症体征和症状与抑郁和焦虑之间的关联。
从一家公立三级眼科专科中心招募成年门诊患者。参与者接受社会人口统计学和干眼症状问卷调查、荧光素染料泪膜破裂时间（TBUT）、荧光素染料角膜染色和泪液分泌试验。采用拉施分析对医院焦虑抑郁量表（HADS）和流行病学研究中心抑郁量表（CES-D）进行内部验证，并确定其心理测量特性。
共招募了96名参与者（平均年龄54.5±10.8岁；64.1%为女性）。CES-D的平均得分为12.1±9.8，28名参与者（31.5%）得分高于16（已公布的阈值）。HADS中与抑郁相关问题的平均得分为3.6±3.6，13名参与者（14.1%）得分≥8。HADS中与焦虑相关问题的平均得分为5.3±3.6，24名参与者（26.1%）得分≥8。泪液分泌试验与CES-D得分之间存在弱负相关。在TBUT较低的干眼症患者中，CES-D中升高的抑郁得分与视力模糊显著相关，但与眼刺激无关。
总之，特定类型的干眼症状，尤其是视力模糊频率增加的症状，与抑郁症状相关。干眼症引起的光学像差，与泪膜不稳定有关，可能易导致抑郁倾向。
