The association between depressive symptoms, diabetes and diabetic retinopathy is likely to be bidirectional, with diabetes impairment complicating depression and vice versa, according to a study in JAMA Ophthalmology.
The cross-sectional study included 519 patients with diabetes, of which 170 individuals (32.8%) were female. Average patient age was 64.9 years.
Researchers utilized the Hospital Anxiety and Depression Scale to measure depression and anxiety symptoms; scores range from 0 to 21, and scores over 8 signify possible anxiety or depression, according to researchers.
A total of 80 individuals (15.4%) screened positive for depressive symptoms, and 118 patients (22.7%) screened positive for symptoms of anxiety.
Diabetic macular edema was not associated with depressive symptoms.
Researchers found that severe nonproliferative diabetic retinopathy (NPDR)/PDR was independently associated with greater depressive symptoms after accounting for sociodemographics and clinical characteristics, including visual acuity.
Furthermore, researchers concluded that a self-reported history of anxiety or depression, longer duration of diabetes, more severe diabetic retinopathy, poorer blood glucose control, lower educational level and severe vision impairment were associated with greater depressive symptoms.
Greater symptoms of anxiety were associated with self-reported history of anxiety or depression, presence of comorbidity, younger age, lower educational level and female sex, according to researchers.
“...Our findings highlight that a simple self-report question about mental health history, which is feasible to implement in clinical practice, with records of vision and diabetic retinopathy status can be used to identify individuals with diabetes who are at risk for poor mental health,” the researchers wrote. – by Abigail Sutton
Disclosure: Rees is funded by National Health and Medical Research Council Career Development Award 1061801. Please see the full study for a complete list of financial disclosures.