The relationship between visual impairment and depression in low vision patients: A systematic review
Keywords:
Low Vision, Depression, Psychiatric Disorder, Mental Health, Visual ImpairmentAbstract
Background and aim: Visual impairment significantly impacts daily activities, quality of life, and future plans, often leading to psychological issues, including anxiety and depression. This study aims to explore the relationship between mental disorders, particularly depression, and visual impairment or low vision.
Methods: A systematic literature search was conducted using online databases such as PubMed, ScienceDirect, Google Scholar, and Scopus. Search terms included combinations of keywords such as low vision, depression, psychiatric disorder, and their synonyms. The initial search yielded 362 publications, which were screened by title and abstract to identify studies that met the inclusion criteria. Nineteen articles were included in this review.
Results: Low vision can affect visual function and psychosocial well-being, impairing the ability to perform daily activities. It is also closely associated with depression and other mental health issues. Individuals with low vision often experience a reduced quality of life and poorer mental health compared to those without visual impairments and may require specialist care to manage their condition.
Conclusions: According to this systematic review, there is a significant correlation between depression and visual impairment.
References
1. Boagey H, K. Jolly J, E. Ferrey A. Psychological Impact of Vision Loss. J Ment Health Clin Psychol. 2022;6(3):25-31. doi:10.29245/2578-2959/2021/3.1256
2. Mark JR, Kulinich AG, Scher LM, et al. Vision Loss and Psychopathology. Pan Am J Ophthal. 2021;3(1):7. doi:10.4103/pajo.pajo_65_20
3. Chen YL, Wu MS, Wang SH, et al. Effectiveness of health checkup with depression screening on depression treatment and outcomes in middle-aged and older adults: a target trial emulation study. Lancet Reg Health West Pac. 2024;43. doi:10.1016/j.lanwpc.2023.100978
4. Siu AL, US Preventive Services Task Force (USPSTF), Bibbins-Domingo K, et al. Screening for Depression in Adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2016;315(4):380-387. doi:10.1001/jama.2015.18392
5. Bhattacharjee S, Goldstone L, Vadiei N, et al. Depression Screening Patterns, Predictors, and Trends Among Adults Without a Depression Diagnosis in Ambulatory Settings in the United States. Psychiatric Serv. 2018;69(10):1098-1100. doi:10.1176/appi.ps.201700439
6. C Okosa M. Psychological Effects of Eye Diseases: A Tertiary Eye Center Study. J Psychiatry Psychiatr Disord. 2021;05(04). doi:10.26502/jppd.2572-519X0139
7. Taipale J, Mikhailova A, Ojamo M, et al. Low vision status and declining vision decrease Health-Related Quality of Life: Results from a nationwide 11-year follow-up study. Qual Life Res. 2019;28(12):3225-3236. doi:10.1007/s11136-019-02260-3
8. Court H, McLean G, Guthrie B, et al. Visual impairment is associated with physical and mental comorbidities in older adults: a cross-sectional study. BMC Med. 2014;12(1):181. doi:10.1186/s12916-014-0181-7
9. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev. 2021;10(1):89. doi:10.1186/s13643-021-01626-4
10. Warsinggih, Aryanti C, Uwuratuw JA, et al. Anastomosis selection in liver transplantation for recipients with unusable recipient hepatic arteries: a bayesian network meta-analysis. BMC Surg. 2024;24(1):96. doi:10.1186/s12893-024-02385-4
11. Grimaldy G, Prasetyo E, Manuhutu YN, et al. Relationship of Hyperbaric Oxygen Therapy with Glasgow Coma Scale (GCS) Dynamics in Traumatic Brain Injury Patients. Indonesia Surg J. 2024;2(1):1-9. https://inasj.org/index.php/inasj/article/view/8
12. Howick J, Chalmers I, Glasziou P, et al. The Oxford 2011 Levels of Evidence. 2011.. https://www.cebm.ox.ac.uk/resources/levels-of-evidence/ocebm-levels-of-evidence
13. Moola S, Munn Z, Tufanaru C, et al. Chapter 7: Systematic reviews of etiology and risk. In: JBI Manual for Evidence Synthesis. JBI; 2020. doi:10.46658/JBIMES-20-08
14. Oley MH, Oley MC, Sukarno V, et al. Advances in Three-Dimensional Printing for Craniomaxillofacial Trauma Reconstruction: A Systematic Review. J Craniofac Surg. 2024;35(7):1926-1933. doi:10.1097/SCS.0000000000010451
15. Choi HG, Lee MJ, Lee SM. Visual impairment and risk of depression: A longitudinal follow-up study using a national sample cohort. Sci Rep. 2018;8(1):2083. doi:10.1038/s41598-018-20374-5
16. Nollett C, Ryan B, Bray N, et al. Depressive symptoms in people with vision impairment: a cross-sectional study to identify who is most at risk. BMJ Open. 2019;9(1):e026163. doi:10.1136/bmjopen-2018-026163
17. Cosh S, Carriere I, Nael V, et al. The association of vision loss and dimensions of depression over 12 years in older adults: Findings from the Three City study. J Affect Disord. 2019;243:477-484. doi:10.1016/j.jad.2018.09.071
18. Nollett C, Bartlett R, Man R, et al. How do community-based eye care practitioners approach depression in patients with low vision? A mixed methods study. BMC Psychiatry. 2019;19(1):426. doi:10.1186/s12888-019-2387-x
19. Choi SU, Chun YS, Lee JK, et al. Comparison of vision-related quality of life and mental health between congenital and acquired low-vision patients. Eye. 2019;33(10):1540-1546. doi:10.1038/s41433-019-0439-6
20. Kohda Y, Monma T, Yamane M, et al. Mental Health Status and Related Factors Among Visually Impaired Athletes. J Clin Med Res. 2019;11(11):729-739. doi:10.14740/jocmr3984
21. Abou‐Hanna JJ, Leggett AN, Andrews CA, et al. Vision impairment and depression among older adults in low‐ and middle‐income countries. Int J Geriatr Psychiatry. 2021;36(1):64-75. doi:10.1002/gps.5394
22. Brunes A, Heir T. Visual impairment and depression: Age-specific prevalence, associations with vision loss, and relation to life satisfaction. World J Psychiatry. 2020;10(6):139-149. doi:10.5498/wjp.v10.i6.139
23. van Munster EPJ, van der Aa HPA, Verstraten P, et al. Barriers and facilitators to recognize and discuss depression and anxiety experienced by adults with vision impairment or blindness: a qualitative study. BMC Health Serv Res. 2021;21(1):749. doi:10.1186/s12913-021-06682-z
24. Bartlett R, Acton JH, Ryan B, et al. Training results in increased practitioner confidence and identification of depression in people with low vision: a mixed methods study. Ophthalmic Physiol Opt. 2021;41(2):316-330. doi:https://doi.org/10.1111/opo.12788
25. Parravano M, Petri D, Maurutto E, et al. Association Between Visual Impairment and Depression in Patients Attending Eye Clinics: A Meta-analysis. JAMA Ophthalmol. 2021;139(7):753-761. doi:10.1001/jamaophthalmol.2021.1557
26. Elsman EBM, van Munster EPJ, van Nassau F, et al. Perspectives on Implementing the Patient Health Questionnaire-4 in Low-Vision Service Organizations to Screen for Depression and Anxiety. Transl Vis Sci Technol. 2022;11(1):16. doi:10.1167/tvst.11.1.16
27. Onyebueke G, Okeke S, Asimadu IN. Burden and Severity of Depression in Nigeria: Relationship and Association with Visual Impairment. Open J Psychiatr. 2022;12(04):311-320. doi:10.4236/ojpsych.2022.124023
28. Gascoyne B, Jolley E, Penzin S, et al. Vision impairment and self-reported anxiety and depression in older adults in Nigeria: evidence from a cross-sectional survey in Kogi State. Int Health. 2022;14(Supplement_1):i9-i16. doi:10.1093/inthealth/ihab070
29. Virgili G, Parravano M, Petri D, et al. The Association between Vision Impairment and Depression: A Systematic Review of Population-Based Studies. J Clin Med. 2022;11(9). doi:10.3390/jcm11092412
30. Munaw MB, Tegegn MT. Visual impairment and psychological distress among adults attending the University of Gondar tertiary eye care and training center, Northwest Ethiopia: A comparative cross-sectional study. PLoS One. 2022;17(2):e0264113. doi:10.1371/journal.pone.0264113
31. Li D, Chan VF, Virgili G, et al. Impact of Vision Impairment and Ocular Morbidity and Their Treatment on Depression and Anxiety in Children: A Systematic Review. Ophthalmology. 2022;129(10):1152-1170. doi:10.1016/j.ophtha.2022.05.020
32. van Munster EPJ, van Nispen RMA, Nollett CL, et al. Discussing depression in patients with visual impairment differs across countries: Validation of a prediction model in healthcare providers. Acta Ophthalmol. 2023;101(7):766-774. doi:https://doi.org/10.1111/aos.15663
33. Tantirattanakulchai P, Hounnaklang N, Pongsachareonnont PF, et al. Impact of COVID-19 on Depressive Symptoms Among Patients with Low Vision and Blindness. Clin Ophthalmol. 2023;Volume 17:789-796. doi:10.2147/OPTH.S401714
34. Dickens P, Miller D, Ramaesh K. Psychological complexities of visual restoration. BMJ Case Rep. 2021;14(1):e237603. doi:10.1136/bcr-2020-237603
35. Mamtani NH, Mamtani HG, Chaturvedi SK. Psychiatric aspects of ophthalmic disorders: A narrative review. Indian J Ophthalmol. 2023;71(5). https://journals.lww.com/ijo/fulltext/2023/05000/psychiatric_aspects_of_ophthalmic_disorders__a.22.aspx
36. Demmin DL, Silverstein SM. Visual Impairment and Mental Health: Unmet Needs and Treatment Options. Clin Ophthalmol. 2020;14:4229-4251. doi:10.2147/OPTH.S258783
37. Kunugi H. Depression and lifestyle: Focusing on nutrition, exercise, and their possible relevance to molecular mechanisms. Psychiatry Clin Neurosci. 2023;77(8):420-433. doi:10.1111/pcn.13551
38. Jung Y, Han K, Wang S min, et al. Effect of depressive symptom and depressive disorder on glaucoma incidence in elderly. Sci Rep. 2021;11(1):5888. doi:10.1038/s41598-021-85380-6
39. Constable PA, Al-Dasooqi D, Bruce R, et al. A Review of Ocular Complications Associated with Medications Used for Anxiety, Depression, and Stress. Clin Optom (Auckl). 2022;Volume 14:13-25. doi:10.2147/OPTO.S355091
40. Kalin NH. The Critical Relationship Between Anxiety and Depression. Am J Psychiatry. 2020;177(5):365-367. doi:10.1176/appi.ajp.2020.20030305
41. Garber J, Weersing VR. Comorbidity of anxiety and depression in youth: Implications for treatment and prevention. Clin Psychol: Sci Pract. 2010;17(4):293-306. doi:10.1111/j.1468-2850.2010.01221.x
42. Cosh S, Naël V, Carrière I, et al. Bidirectional associations of vision and hearing loss with anxiety: prospective findings from the Three-City Study. Age Ageing. 2018;47(4):582-589. doi:10.1093/ageing/afy062
43. Ali M, Sharif MO, Naseema N. Psychological impacts of visual impairments in different working age groups. J Xi’an Shiyou University. 2022;18(12). Accessed October 24, 2024. https://www.xisdxjxsu.asia/V18I12-66.pdf
44. Lupón M, Armayones M, Cardona G. Quality of life among parents of children with visual impairment: A literature review. Res Dev Disabil. 2018;83:120-131. doi:https://doi.org/10.1016/j.ridd.2018.08.013
45. Meer EA, Lee YH, Repka MX, et al. Association of Mood Disorders, Substance Abuse, and Anxiety Disorders in Children and Teens With Serious Structural Eye Diseases. Am J Ophthalmol. 2022;240:135-142. doi:10.1016/j.ajo.2022.03.016
46. Singh RP, Sharma P. Depression Among Geriatrics: Prevalence And Risk Factors. Nat J Res Community Med. 2019;8(2):117. doi:10.26727/NJRCM.2019.8.2.117-120
47. Zhao KX, Huang CQ, Xiao Q, et al. Age and risk for depression among the elderly: a meta-analysis of the published literature. CNS Spectr. 2012;17(3):142-154. doi:10.1017/S1092852912000533
48. Moghadam MRSF, Etemadi S, Jandari S, et al. Depression in an over-55 years old community-dwelling elderly healthy population: from prevalence to social-economic state, lifestyle and Nutrients – A population-based study. Res sq. 2022. doi:10.21203/rs.3.rs-1531230/v1
49. Maier A, Riedel-Heller SG, Pabst A, et al. Risk factors and protective factors of depression in older people 65+. A systematic review. PLoS One. 2021;16(5):e0251326. doi:10.1371/journal.pone.0251326
50. Szymkowicz SM, Gerlach AR, Homiack D, et al. Biological factors influencing depression in later life: role of aging processes and treatment implications. Transl Psychiatry. 2023;13(1):160. doi:10.1038/s41398-023-02464-9
51. Barua A, Kademane K, Das B, et al. Visual impairment and depression. J Geriatr Care Res. 2014;1:8-10.
52. Amilon A, Siren A. The link between vision impairment and depressive symptomatology in late life: does having a partner matter? Eur J Ageing. 2022;19(3):521-532. doi:10.1007/s10433-021-00653-3
53. Holloway EE. Preventing depression in low vision patients: Implementation and scale-up of an early psychological intervention for depressive symptoms. Invest Ophthalmol Vis Sci. 2018;59(9):1200.
54. Gong X, Ni Z, Wu B. The mediating roles of functional limitations and social support on the relationship between vision impairment and depressive symptoms in older adults. Ageing Soc. 2020;40(3):465-479. doi:10.1017/S0144686X18001010
55. Shah P, Schwartz SG, Gartner S, et al. Low vision services: a practical guide for the clinician. Ther Adv Ophthalmol. 2018;10. doi:10.1177/2515841418776264
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