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Prevalence and risk factors for anxiety and depression and its impact on management compliance in patients with Diabetic Retinopathy (DR)

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First Author: K.Dole INDIA

Co Author(s):    G. Kumar   N. Rawal   S. Kulkarni   R. Deshpande   M. Deshpande        

Abstract Details

Purpose:

DR and its potential consequence can generate fear in individuals that they may go blind can be a risk for achieving good mental health. This can manifest in development of anxiety and depression. We also know that non compliance to screening and treatment is big challenge in patients with DR and we need to have holistic approach to address this problem. Psychology plays important role in adhering to treatment guidelines so this study was planned to assess the prevalence and risk factors for anxiety and depression in patient with diabetic retinopathy (DR) and its impact on management compliance.

Setting:

Study was conducted at retina department of a tertiary eye care center located in western Maharashtra. The study was planned in consultation with qualified psychiatrist.

Methods:

A cross sectional observational study was carried on 72 patients attending retina clinic of a tertiary eye care hospital located in western Maharashtra. After getting approval from institutional ethics committee, written informed consent was taken. All diabetic retinopathy (DR) patients underwent a thorough ophthalmic examination.The severity of diabetic retinopathy was measured in the worse eye. Anxiety was assessed by GAD-7 and depression was assessed by PHQ-9, and Compliance to management was assessed by checking whether patient followed scheduled appointment or not. And responses analysed statistically using SPSS version 21.0 software.

Results:

The study had 48(66.7%) males. 64 % were educated up to 10th standard. 51.4% were nonworking. Median diabetes mellitus duration was 11.2 year. Prevalence of anxiety was mild 13 (18.1%), moderate 08(11.1%) and severe 02(2.8%). Prevalence of depression was mild 06(8.3%), moderate (9.7%), moderate to severe 08(11.1%), severe 02(2.8%). Anxiety and depression were more in males, married persons, education level below 10th standard, and lower income level. Anxiety and depression was more in vision threatening DR patients and increased with the duration of DR and age. Compliance to management was not affected by anxiety (p=0.931) but was significantly affected by depression (p=0.016).

Conclusions:

The study showed that the prevalence of anxiety and depression was high in patients with diabetic retinopathy and a holistic approach in the form of psychological counselling and if needed anti-depressant is needed to ensure better compliance to management options so as to prevent vision loss from DR.

Financial Disclosure:

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