For low vision specialists and those who consult them
More evidence of the association between depression and visual impairment
February 24, 2010Posted by on
There is a new paper in Investigative Ophthalmology and Vision Science which assesses the incidence of depression amongst people with visual impairment.
The authors interviewed 143 adults with visual impairment (vision worse than 6/12 or 20/40). 15% of their sample were identified as having ‘moderate depression’ by use of a standard instrument (the PHQ-9). One person had severe depression, for which they were already taking antidepressant medication.
The authors also find that younger adults were more likely to have depression than the older people they assessed. They show that this is not confounded by the length of time people have had visual impairment, but is indeed to do with the age at which people develop poor vision. They speculate that this is due to the increased burden of work and family commitments of younger people, or the fact that they have developed less successful coping strategies than older people.
This type of research is difficult to perform, and it is particularly difficult to determine causality from a cross-sectional report like this: would some of the people with depression have been depressed if they didn’t have vision loss? Quite possibly, as depression is so common. I was struck by the presentation by Dr Schwartz at the AAO meeting, where he pointed out that optometrists will see more people with depression than with blepharitis (a very common inflammation of the eyelids) in the average day.
This paper adds to the volume of research showing that people with visual impairment are at increased risk of depression. I am aware that as clinicians working in low vision clinics we should be screening for depression in the people which we see, yet I still find it difficult to broach this subject in the consulting room. As I have previously discussed, I think further training for low vision professionals in communication skills and identifying mental health problems is long overdue.