Department of Ophthalmology, Stein Eye Institute, University of California, Los Angeles, Los Angeles.
Department of Ophthalmology, Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
JAMA Ophthalmol. 2022 Apr 1;140(4):373-381. doi: 10.1001/jamaophthalmol.2022.0137.
Children with strabismus have poorer functional vision and decreased quality of life than those without strabismus.
To evaluate the association between strabismus and mental illness among children.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study analyzed claims data from the OptumLabs Data Warehouse, a longitudinal deidentified commercial insurance claims database, from 12 005 189 patients enrolled in the health plan between January 1, 2007, and December 31, 2017. Eligibility criteria included age younger than 19 years at the time of strabismus diagnosis, enrollment in the health plan between 2007 and 2018, and having at least 1 strabismus claim based on International Classification of Diseases, Ninth Revision, Clinical Modification and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Clinical Modification codes. Controls were children in the same database with no eye disease codes other than refractive error reported. Demographic characteristics and mental illness claims were compared. Statistical analysis was conducted from December 1, 2018, to July 31, 2021.
Presence of mental illness claims.
Among the 12 005 189 patients (6 095 523 boys [50.8%]; mean [SD] age, 8.0 [5.9] years) in the study, adjusted odds ratios for the association of mental illnesses with strabismus were 2.01 (95% CI, 1.99-2.04) for anxiety disorder, 1.83 (95% CI, 1.76-1.90) for schizophrenia, 1.64 (95% CI, 1.59-1.70) for bipolar disorder, 1.61 (95% CI, 1.59-1.63) for depressive disorder, and 0.99 (95% CI, 0.97-1.02) for substance use disorder. There was a moderate association between each strabismus type (esotropia, exotropia, and hypertropia) and anxiety disorder, schizophrenia, bipolar disorder, and depressive disorder; odds ratios ranged from 1.23 (95% CI, 1.17-1.29) for the association between esotropia and bipolar disorder to 2.70 (95% CI, 2.66-2.74) for the association between exotropia and anxiety disorder.
This cross-sectional study suggests that there was a moderate association between strabismus and anxiety disorder, schizophrenia, bipolar disorder, and depressive disorder but not substance use disorder. Recognizing that these associations exist should encourage mental illness screening and treatment for patients with strabismus.
斜视儿童的功能性视力和生活质量比没有斜视的儿童差。
评估斜视与儿童精神疾病之间的关联。
设计、地点和参与者：这项横断面研究分析了来自 OptumLabs Data Warehouse 的索赔数据，该数据库是一个纵向去识别商业保险索赔数据库，包含了 2007 年 1 月 1 日至 2017 年 12 月 31 日期间参与健康计划的 12005189 名患者。入选标准包括在斜视诊断时年龄小于 19 岁、在 2007 年至 2018 年期间参加健康计划以及至少有 1 次基于国际疾病分类第 9 修订版临床修正和国际疾病分类第 10 修订版临床修正的斜视索赔。对照组为数据库中无眼部疾病报告的儿童，除屈光不正外。比较了人口统计学特征和精神疾病索赔。统计分析于 2018 年 12 月 1 日至 2021 年 7 月 31 日进行。
存在精神疾病索赔。
在这项研究的 12005189 名患者（6095523 名男孩[50.8%]；平均[SD]年龄为 8.0[5.9]岁）中，焦虑障碍、精神分裂症、双相情感障碍、抑郁障碍与斜视的关联的调整后比值比分别为 2.01（95%CI，1.99-2.04）、1.83（95%CI，1.76-1.90）、1.64（95%CI，1.59-1.70）、1.61（95%CI，1.59-1.63）和 0.99（95%CI，0.97-1.02）。每种斜视类型（内斜视、外斜视和上斜视）与焦虑障碍、精神分裂症、双相情感障碍和抑郁障碍均存在中度关联；比值比范围从 1.23（95%CI，1.17-1.29）到 2.70（95%CI，2.66-2.74），分别为内斜视与双相情感障碍的关联和外斜视与焦虑障碍的关联。
这项横断面研究表明，斜视与焦虑障碍、精神分裂症、双相情感障碍和抑郁障碍之间存在中度关联，但与物质使用障碍无关。认识到这些关联的存在应该鼓励斜视患者进行精神疾病筛查和治疗。
