Publication: Anxiety and depression with its associated factors in primary open angle glaucoma patients
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Date
2021
Authors
Kwok, Iu Kwang
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Abstract
INTRODUCTION Anxiety and depression are associated with chronic medical illness. Primary open angle glaucoma (POAG) is a chronic disease and requires lifelong treatment. Psychological aspect is often overlooked during the course of glaucoma management. The awareness and knowledge of anxiety and depression in glaucoma in our local setting is still inadequate. Screening of anxiety and depression at different severity stage of POAG is essential to detect the psychological disorder at its early stage and help to better manage glaucoma treatment. OBJECTIVE The aim of this study is to compare the anxiety and depression score between different types of glaucoma severity (mild, moderate, severe) and to identify the associated factors of the anxiety and depression using HADS in primary open angle glaucoma patients METHODS A cross-sectional study was conducted involving 191 patients diagnosed with POAG with no chronic ocular disease except cataract. They were grouped into mild, moderate and severe group based on the better eye using modified AGIS scoring system with two reliable and reproducible SITA standard 24-2 Humphrey visual field results. Depression and anxiety scoring were evaluated using Hospital Anxiety Depression Scale (HADS) which consist of two subscales, Anxiety (HADS-A) and Depression (HADS-D) with scoring ranges from 0-21. The scoring for each subscale were compared among three POAG severity groups and its associated factors. RESULTS HADS-A and HADS-D score was significantly lower in mild severity (3.48±2.77; 3.57±3.29) group compare to moderate (5.21±2.51, p<0.001; 4.99±2.57, p=0.031) and severe (6.54±0.85, p=0.009, 7.01±4.29, p<0.026) group respectively. A younger age group (b= -0.14, p<0.001), duration of glaucoma (b= 0.43, p<0.001), number of antiglaucoma (b= 1.95, p=0.003) and bilateral blindness (b= 1.53, p=0.005) were associated with higher HADS-A score. Significant independent predictor of higher HADS-D score were seen younger subjects (b= -0.13, p< 0.001), duration of glaucoma (b=0.44, p<0.001), financial responsibility (b= 1.07, p< 0.029) and history of glaucoma surgery (b= 2.31, p< 0.05). CONCLUSION Severity of POAG is an independent predictor of HADS score. Glaucoma severity associated with higher level of anxiety and depression. Younger age, longer duration of glaucoma, higher number of anti-glaucoma and bilateral blindness were associated factors for anxiety whereas younger age, longer duration of glaucoma and history of glaucoma surgery were associated factors for depression.
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