Juntendo University Faculty of Medicine, Department of Ophthalmology, Tokyo, Japan; Juntendo University Faculty of Medicine, Department of Strategic Operating Room Management and Improvement, Tokyo, Japan.
Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan; Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
Ocul Surf. 2020 Apr;18(2):312-319. doi: 10.1016/j.jtos.2020.02.007. Epub 2020 Feb 27.
Dry eye (DE) disease and depression are increasing in modern times. We investigated the association between DE and depressive symptoms using the iPhone application, DryEyeRhythm.
This large-scale crowdsourced observational study was conducted within iPhone users in Japan who downloaded DryEyeRhythm. Participants with a Zung Self-rating Depression Scale (SDS) score ≥ 40 were defined as having depressive symptoms, and those with an Ocular Surface Disease Index (OSDI) score ≥ 13 were defined as having DE symptoms (mild, 13-22; moderate, 23-32; and severe, 33-100). We compared SDS scores between participants with normal eye and mild, moderate, and severe OSDI-based DE symptoms. Logistic regression analyses were used to determine the association between DE severity and depressive symptoms after adjustment for demographic characteristics, medical history, and lifestyle habits.
This study included 4454 participants (mean age, 27.9 ± 12.6 years; female, 66.7%). Participants with SDS scores ≥40 accounted for 58.2%, 70.9%, 79.4%, and 85.0% of normal controls and participants with mild, moderate, and severe DE symptoms, respectively (P trend < 0.001). The adjusted odds ratios (95% confidence interval) for depressive symptoms (SDS score of ≥40) were 1.62 (1.35-1.95) for mild, 2.39 (1.92-2.97) for moderate, and 3.29 (2.70-4.00) for severe DE symptoms.
This large-scale crowdsourced clinical study using DryEyeRhythm suggests that depressive symptoms are more common in individuals with more severe DE symptoms. DryEyeRhythm could play a role in earlier prevention or future prospective interventions for depressive symptoms in individuals with DE symptoms.
干眼症（DE）和抑郁症在现代社会呈上升趋势。我们使用 iPhone 应用程序 DryEyeRhythm 调查了 DE 与抑郁症状之间的关系。
本大规模众包观察性研究在日本下载了 DryEyeRhythm 的 iPhone 用户中进行。zung 自评抑郁量表（SDS）评分≥40 的参与者被定义为患有抑郁症状，眼表疾病指数（OSDI）评分≥13 的参与者被定义为患有 DE 症状（轻度，13-22；中度，23-32；和重度，33-100）。我们比较了正常眼和轻度、中度和重度 OSDI 为基础的 DE 症状的参与者的 SDS 评分。使用逻辑回归分析来确定在调整人口统计学特征、病史和生活方式习惯后，DE 严重程度与抑郁症状之间的关联。
本研究共纳入 4454 名参与者（平均年龄 27.9±12.6 岁；女性占 66.7%）。SDS 评分≥40 的参与者分别占正常对照组和轻度、中度和重度 DE 症状参与者的 58.2%、70.9%、79.4%和 85.0%（P 趋势<0.001）。抑郁症状（SDS 评分≥40）的调整后比值比（95%置信区间）为轻度 1.62（1.35-1.95）、中度 2.39（1.92-2.97）和重度 3.29（2.70-4.00）。
本研究使用 DryEyeRhythm 进行的大规模众包临床研究表明，抑郁症状在 DE 症状更严重的个体中更为常见。DryEyeRhythm 可能在 DE 症状患者的抑郁症状早期预防或未来前瞻性干预中发挥作用。
