Kaiser Tina, Janssen Birgit, Schrader Stefan, Geerling Gerd
Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Bergische Landstraße 2, 40629, Düsseldorf, Germany.
Department of Psychiatry and Psychotherapy, LVR-Klinik Langenfeld, Langenfeld, Germany.
Graefes Arch Clin Exp Ophthalmol. 2019 Mar;257(3):591-599. doi: 10.1007/s00417-019-04241-1. Epub 2019 Jan 15.
Dry eye disease (DED) is a multifactorial disease of the ocular surface that leads to symptoms of discomfort and reduces quality of life. Several studies have shown an association with depression. We investigated the prevalence of depressive symptoms and their severity in DED patients and examined whether depressive symptoms correlate with signs, symptoms, or subtypes of DED or with psychological factors (resilience, premorbid personality, and subjective well-being).
This cross-sectional study (n = 64, mean age 56.72, 70% women) was conducted at the Dry Eye Clinic of the Department of Ophthalmology, University Hospital Düsseldorf. Psychological assessment included the Beck Depression Inventory, revised version (BDI-II); World Health Organization Well-Being Index (WHO-5); 13-item Resilience Scale (RS-13); and Munich Personality Test (MPT). DED parameters were assessed by the Ocular Surface Disease Index (OSDI), Schirmer test (ST), tear film break-up time (TBUT), and corneal fluorescein staining (CFS). As the reference for the BDI-II depression score, we used standard values from a German sample of healthy individuals (n = 582, 66% women). Multivariate logistic regression analysis was performed to investigate the effects of various parameters on depressive symptoms. Associations between variables were examined by Pearson or Spearman correlation tests.
Among all participants, 61% had depressive symptoms (25% minimal, 14% mild, 17% moderate, and 5% severe). The mean BDI-II score (11.95, ± 8.46) was significantly higher than in the healthy reference group (p < .0001). It was not correlated with the severity of signs or symptoms of DED or with its subtypes, but it was significantly negatively correlated with resilience (p < .0001) and subjective well-being (p < .0001). Depressive symptoms were negatively correlated with the premorbid personality trait extraversion (p = .036) and frustration tolerance (p < .0001) and positively correlated with premorbid neuroticism (p = .001), isolation tendencies (p = .014), and esoteric tendencies (p = .001).
Depressive symptoms of all degrees of severity are common in DED patients, but they are not associated with the severity of signs or symptoms of DED. Subjective well-being, resilience, and premorbid personality do not correlate with the signs or symptoms of DED, but they do correlate with depressive symptoms.
干眼疾病（DED）是一种眼表的多因素疾病，可导致不适症状并降低生活质量。多项研究表明其与抑郁症有关。我们调查了DED患者抑郁症状的患病率及其严重程度，并研究了抑郁症状是否与DED的体征、症状、亚型或心理因素（心理韧性、病前人格和主观幸福感）相关。
这项横断面研究（n = 64，平均年龄56.72岁，70%为女性）在杜塞尔多夫大学医院眼科干眼门诊进行。心理评估包括贝克抑郁量表修订版（BDI-II）、世界卫生组织幸福感指数（WHO-5）、13项心理韧性量表（RS-13）和慕尼黑人格测试（MPT）。通过眼表疾病指数（OSDI）、泪液分泌试验（ST）、泪膜破裂时间（TBUT）和角膜荧光素染色（CFS）评估DED参数。作为BDI-II抑郁评分的参考，我们使用了来自德国健康个体样本（n = 582，66%为女性）的标准值。进行多变量逻辑回归分析以研究各种参数对抑郁症状的影响。通过Pearson或Spearman相关性检验检查变量之间 的关联。
在所有参与者中，61%有抑郁症状（25%为轻度，14%为中度，17%为中度，5%为重度）。BDI-II平均得分（11.95，±8.46）显著高于健康对照组（p <.0001）。它与DED体征或症状的严重程度及其亚型无关，但与心理韧性（p <.0001）和主观幸福感（p <.0001）显著负相关。抑郁症状与病前人格特质外向性（p = 0.036）和挫折耐受力（p <.0001）呈负相关，与病前神经质（p = 0.001）、孤独倾向（p = 0.014）和神秘主义倾向（p = 0.001）呈正相关。
DED患者中各种严重程度的抑郁症状都很常见，但它们与DED体征或症状的严重程度无关。主观幸福感、心理韧性和病前人格与DED的体征或症状无关，但与抑郁症状相关。
