Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy.
Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL; and.
Cornea. 2024 Feb 1;43(2):237-244. doi: 10.1097/ICO.0000000000003284. Epub 2023 Apr 5.
The aim of this study was to delineate the personality traits of patients affected by keratoconus (KC) compared with a group of nonkeratoconic controls matched in age and sex.
In this prospective interventional case-control study, 60 consecutive subjects (30 KC cases and 30 healthy controls), aged 18 to 30, were enrolled at the time of their first encounter at the ophthalmology unit of the Fondazione Policlinico "Tor Vergata", Roma. After completing the ophthalmic evaluation, participants were asked to respond to the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25). A complete psychiatric assessment was performed, including the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (SCID-5); the Symptom Check List-90-Revised (SCL-90); the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Modified (TEMPS-M); and the NEO Five-Factor Inventory (NEO-FFI).
Cases had lower quality of life than controls, as demonstrated by lower scores in all NEI VFQ-25 subdomains. Nine patients with KC (30.0%) were diagnosed by the SCID-5 with at least 1 cluster C personality disorder, resulting in a 9-fold increased risk compared with controls. Moreover, keratoconic patients showed a more pronounced psychosomatic symptomatology (SCL-90) and a characteristic neurotic temperament (TEMPS-M and NEO-FFI).
Our results support the hypothesis that subjects with KC feature dysfunctional coping mechanisms and personality traits, which might already be present at the first clinical encounter. Ophthalmologists should question the mental and emotional status of patients with KC and be especially careful in managing these patients.
本研究旨在描述与年龄和性别相匹配的非圆锥角膜对照组相比，圆锥角膜（KC）患者的人格特征。
在这项前瞻性的干预性病例对照研究中，共纳入了 60 名连续患者（30 名 KC 患者和 30 名健康对照组），年龄在 18 至 30 岁之间，他们均在罗马 Tor Vergata 综合医院眼科接受了首次检查。在完成眼科评估后，参与者被要求回答国家眼科研究所视觉功能问卷-25（NEI VFQ-25）。进行了全面的精神病学评估，包括诊断和统计手册第五版的结构临床访谈（SCID-5）；症状清单-90 修订版（SCL-90）；孟菲斯、比萨、巴黎和圣地亚哥改良的 Memphis 气质评估（TEMPS-M）；和五因素人格量表（NEO-FFI）。
与对照组相比，病例组的生活质量较低，表现在所有 NEI VFQ-25 子域的评分均较低。9 名 KC 患者（30.0%）被 SCID-5 诊断为至少有一种 C 类人格障碍，与对照组相比，风险增加了 9 倍。此外，圆锥角膜患者表现出更明显的身心症状（SCL-90）和特有的神经质气质（TEMPS-M 和 NEO-FFI）。
我们的研究结果支持了这样一种假设，即 KC 患者的特征是存在功能失调的应对机制和人格特征，这些特征可能在首次临床就诊时就已经存在。眼科医生应该询问 KC 患者的精神和情绪状况，并在管理这些患者时特别小心。
