Risk factors for anxiety and depression in patients diagnosed with glaucoma at the Philippine General Hospital

  • Christine Siguan Bell Cebu Institute of Medicine/ university of the Philippines-Philippine General Hospital
  • Nilo Vincent D.G. Florcruz
Keywords: anxiety, depression, glaucoma, Hospital Anxiety and Depression Scale, psychological disturbance

Abstract

Objective: The main objective of this study is to identify the risk factors associated with anxiety and depression among Filipino patients with glaucoma at a tertiary hospital in Manila. The study also aims to determine the sociodemographic profile of patients diagnosed with glaucoma based on age, sex, and social history. Additionally, the study seeks to determine the prevalence of anxiety and depression among Filipino glaucoma patients.

Methods: This is a single-center, cross-sectional study. The levels of anxiety and depression in 82 glaucoma patients, seen in a tertiary hospital in Manila, were evaluated using the Filipino version of the Hospital Anxiety and Depression Scale (HADS-P) questionnaire, which consists of two subscales, representing HADS-anxiety (HADS-A) and HADS-depression (HADS-D). The sociodemographic profile of the glaucoma patients was identified using percentages and frequency distribution. The prevalence of anxiety and depression among the participants was determined using percentages. To identify the risk factors for anxiety and depression, Pearson correlation and linear regression analysis were performed with the HADS-A and HADS-D subscores as dependent variables and demographic and clinical features as independent variables.

Results: After analyzing the data available, it was noted that HADS-A score ≥ 11 was present in 15% of cases, indicating anxiety among the glaucoma patients. Borderline cases of anxiety were observed in 20% (HADS-A score of 8-10), and 65% were normal, with HADS-A scores of ≤ 7. Clinically diagnosed (HADS-D score of ≥11) cases of depression were 1%, borderline cases (HADS-D 8-10) were 12%, and patients with normal HADS-D score were 87%. The linear regression analysis revealed the following results: a significant relationship between the HADS-A subscore and age (B = −0.07, p = 0.0129); a significant relationship between the logarithm of minimum angular resolution (logMAR) best corrected visual acuity (BCVA) of the worse eye and HADS-A subscore (B = 0.424, p = 0.086); and the mean deviation of the worse eye and HADS-A subscore (B = 0.078, p = 0.025). The linear regression analysis revealed the following statistically significant relationships: HADS-D subscores and age (B = −0.06, p = 0.0125); logMAR BCVA of the worse eye and HADS-D subscore (B = 0.541, p = 0.006); mean deviation of the worse eye and HADS-D subscore (B = 0.070, p = 0.016); and mean deviation of the better eye and HADS-D subscore (B = 0.097, p = 0.032).

Conclusion: This study shows that the prevalence of anxiety is higher than that of depression in patients with glaucoma. It can also be concluded that younger age is a risk factor for both anxiety and depression. The patient’s visual acuity in the worse eye and visual field severity are also risk factors for both anxiety and depression. It is therefore essential for physicians to be aware of the risk factors for anxiety and depression in patients with glaucoma and to provide glaucoma patients with appropriate psychological care, in addition to ophthalmological care, to prevent the development of these psychological conditions.

References

Janz NK, Wren PA, Guire KE, et al. Fear of blindness in the Collaborative Initial Glaucoma Treatment Study: patterns and correlates over time. Ophthalmology. 2007;114:2213-2220.

Jampel HD, Frick KD, Janz NK, et al. Depression and mood indicators in newly diagnosed glaucoma patients. Am J Ophthalmol. 2007;144:238-244.

Mabuchi F, Yoshimura K, Kashiwagi K, et al. High prevalence of anxiety and depression in patients with primary open-angle glaucoma. J Glaucoma. 2008;17:552-557.

Wang SY, Singh K, Lin SC. Prevalence and predictors of depression among participants with glaucoma in a nationally representative population sample. Am J Ophthalmol. 2012;154:436. e2-444.e2.

Chan EW, Chiang, PP, Liao J, et al. Glaucoma and associated visual acuity and field loss significantly affect glaucoma-specific psychosocial functioning. Ophthalmology. 2014;122:494-501; Manuscript no. 2014-89.

American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. 5th ed. Washington, DC: American Psychiatric Association; 2013:222.

Tastan S, Iyigun E, Bayer A, et al. Anxiety, depression, and quality of life in Turkish patients with glaucoma. Psychol Rep. 2010;106:343-357.

Mabuchi F, Yoshimura K, Kashiwagi K, et al. Risk factors for anxiety and depression in patients with glaucoma. Br J Ophthalmol. 2012;96:821-825.

Zhou C, Qian S, Wu P, et al. Anxiety and depression in Chinese patients with glaucoma: sociodemographic, clinical, and self-reported correlates. J Psychosom Res. 2013;75:75-82.

Kong XM, Zhu WQ, Hong JX, et al. Is glaucoma comprehension associated with psychological disturbance and vision-related quality of life for patients with glaucoma? A cross-sectional study. BMJ Open. 2014;4:e004632. doi:10.1136/bmjopen-2013-004632

Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67:361-370.

Kugaya A, Akechi T, Okuyama T, et al. Screening for psychological distress in Japanese cancer patients. Jpn J Clin Oncol. 1998;28:333e8.

Astejada MN, Jamora RD, Ledesma LK, Bacsal FE. Screening for anxiety and depression among adult Filipino epileptics using the Hospital Anxiety and Depression Scale. Neurol Asia. 2004;9(Suppl 1):137.

Tan SK, Benedicto J, Santiaguel J, et al. Prevalence of anxiety and depression among Filipino patients with chronic obstructive pulmonary disease: a multi-center study. 2012. Unpublished.

Tan SK, Benedicto J, Santiaguel J, et al. Determinants of anxiety and depression among Filipino patients with chronic obstructive pulmonary disease: a multi-center study. Eur Respir J. 2013;42(Suppl. 57):P4183.

Cubillan LDP, Santos EO. Third national survey on blindness. Philipp J Ophthalmol. 2005;30:100-114.

Lloyd GG. Psychological precursors of physical illness: textbook of general hospital psychiatry. Churchill Livingstone; 1991:15.

Fasih U, Hamirani MM, Asad R, Riaz U. Assessment of anxiety and depression in primary open angle glaucoma patients. Pakistan J Ophthalmol. 2010;26(3):143-147.

Wang W, Chair SY, Thompson DR, et al. A psychometric evaluation of the Chinese version of the Hospital Anxiety and Depression Scale in patients with coronary heart disease. J Clin Nurs. 2009;18:1908-1915.

de Guzman MLRE. A validation of the hospital anxiety and depression scale (HADS) in the medically-ill. Acta Medica Philippina. 2013;47(3):53-62.

WHOQOL group. Study protocol for the World Health Organization project to develop a Quality of Life assessment instrument (WHOQOL). Qual Life Res. 1993;2:153-159.

Spaeth G, Walt J, Keener J. Evaluation of quality of life for patients with glaucoma. Am J Ophthalmol. 2006;141:S3-S14.

Published
2019-11-23
How to Cite
Bell, C., & Florcruz, N. V. (2019). Risk factors for anxiety and depression in patients diagnosed with glaucoma at the Philippine General Hospital. Asian Journal of Ophthalmology, 16(4), 329-344. https://doi.org/10.35119/asjoo.v16i4.415