Bitar Maya S, Olson Daniel J, Li Menbing, Davis Richard M
Department of Ophthalmology, Marshall University, Huntington, WV.
Department of Ophthalmology, University of North Carolina, Chapel Hill, NC.
Cornea. 2019 Jun;38(6):684-689. doi: 10.1097/ICO.0000000000001932.
To determine whether improvement in the severity of dry eye disease (DED) symptoms correlates with improvement in anxiety and depression.
This prospective interventional case series recruited 45 adults with evidence of DED. Patients were administered the University of North Carolina Dry Eye Management Scale (DEMS), Generalized Anxiety Disorder 7-item scale (GAD-7), and Personal Health Questionnaire Depression Scale (PHQ-8) to evaluate the severity of DED symptoms, anxiety, and depression, respectively. Standard of care treatment was provided for patients for 3 to 6 months, followed by re-administration of the DEMS, GAD-7, and PHQ-9 surveys. Statistical analysis was performed to assess the relationships between changes in survey scores.
Participants had a mean age of 65.5 (SD, 13.3) years, and 37 (84.6%) were women. Seven patients were lost to follow-up. DEMS and GAD-7 significantly improved from 5.8 ± 1.8 to 4.6 ± 0.2.2 (P = 0.01) and from 5.6 ± 5.5 to 3.3 ± 4.6 (P = 0.05), respectively. Changes in DEMS correlated with changes in PHQ-8 (ρ = 0.3 P = 0.05), but not with changes in GAD-7 (ρ = 0.2 P = 0.3). Changes in DEMS correlated with changes in both PHQ-8 and GAD-7 in the subgroup of patients without prior depression or anxiety diagnosis (ρ = 0.6, P = 0.002; ρ = 0.4, P = 0.02). A multivariate analysis showed that the relationship between DEMS, PHQ-8, and GAD-7 was independent of a prior diagnosis of depression or anxiety and of the presence of comorbidities.
There is a significant correlation between the severity of DED and symptoms of depression and anxiety. Effective DED treatment could have a positive impact on the symptoms of depression and anxiety.
确定干眼疾病（DED）症状严重程度的改善是否与焦虑和抑郁的改善相关。
本前瞻性干预性病例系列研究招募了45名有DED证据的成年人。分别对患者进行北卡罗来纳大学干眼管理量表（DEMS）、广泛性焦虑障碍7项量表（GAD-7）和个人健康问卷抑郁量表（PHQ-8）评估，以分别评估DED症状、焦虑和抑郁的严重程度。为患者提供3至6个月的标准护理治疗，随后再次进行DEMS、GAD-7和PHQ-9调查。进行统计分析以评估调查分数变化之间的关系。
参与者的平均年龄为65.5（标准差，13.3）岁，37名（84.6%）为女性。7名患者失访。DEMS和GAD-7分别从5.8±1.8显著改善至4.6±0.2（P = 0.01）和从5.6±5.5改善至3.3±4.6（P = 0.05）。DEMS的变化与PHQ-8的变化相关（ρ = 0.3，P = 0.05），但与GAD-7的变化无关（ρ = 0.2，P = 0.3）。在无先前抑郁或焦虑诊断的患者亚组中，DEMS的变化与PHQ-8和GAD-7的变化均相关（ρ = 0.6，P = 0.002；ρ = 0.4，P = 0.02）。多变量分析表明，DEMS、PHQ-8和GAD-7之间的关系独立于先前的抑郁或焦虑诊断以及合并症的存在。
DED的严重程度与抑郁和焦虑症状之间存在显著相关性。有效的DED治疗可能对抑郁和焦虑症状产生积极影响。
