Ludwig M Heindl1,2, Marc Trester3, Yongwei Guo4, Florian Zwiener4, Narges Sadat4, Nicola S Pine5, Keith R Pine6, Andreas Traweger7,8, Alexander C Rokohl4. 1. Department of Ophthalmology, Faculty of Medicine, University Hospital of Cologne, University of Cologne, Kerpener Strasse 62, 50924, Cologne, Germany. ludwig.heindl@uk-koeln.de. 2. Center for Integrated Oncology (CIO) Aachen-Bonn-Cologne-Dusseldorf, Cologne, Germany. ludwig.heindl@uk-koeln.de. 3. Trester-Institute for Ocular Prosthetics and Artificial Eyes, Cologne, Germany. 4. Department of Ophthalmology, Faculty of Medicine, University Hospital of Cologne, University of Cologne, Kerpener Strasse 62, 50924, Cologne, Germany. 5. Auckland District Health Board, Auckland, New Zealand. 6. School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand. 7. Institute for Tendon and Bone Regeneration, Spinal Cord Injury and Tissue Regeneration Centre Salzburg, Paracelsus Medical University, Salzburg, Austria. 8. Austrian Cluster for Tissue Regeneration, Vienna, Austria.
Abstract
PURPOSE: To investigate anxiety and depression levels in prosthetic eye-wearing patients using standardized psychometric instruments, to define factors associated with these psychological diseases, and to identify a potential healthcare gap. METHODS: A total of 295 prosthetic eye wearers were screened using the 7-item generalized anxiety disorder scale (GAD-7) and the 9-item patient health questionnaire (PHQ-9). Scores of GAD-7 and PHQ-9 were correlated with scores of general physical and mental health functioning, vision-related quality of life, appearance-related distress, appearance-related social function, and further biosocial factors. RESULTS: Five patients (2%) had a pre-diagnosed anxiety disorder, and 20 patients (7%) had a pre-diagnosed depression. However, our screening revealed 26 patients (9%) with anxiety symptoms, 31 patients (11%) with depression symptoms, and 40 patients (14%) suffering from both anxiety and depression symptoms. This underdiagnosing for both anxiety and depression disorders was significant (p < 0.001, respectively). Higher GAD-7 scores were significantly associated with higher PHQ-9 scores, lower appearance-related social function, lower mental health functioning, and female gender (p ≤ 0.021, respectively). Higher PHQ-9 scores were significantly associated with lower physical and mental health functioning, higher educational degree, and non-traumatic eye loss (p ≤ 0.038, respectively). CONCLUSIONS: Anxiety and depression disorders seem to be underdiagnosed in prosthetic eye wearers and to have higher incidence compared with the general population. Therefore, a psychometric screening should be routinely implemented in the clinical care. For a successful long-term rehabilitation, integrated care by a multidisciplinary team including ophthalmic plastic surgeons, ophthalmologists, ocularists, general practitioners, and psychologists is essential.
PURPOSE: To investigate anxiety and depression levels in prosthetic eye-wearing patients using standardized psychometric instruments, to define factors associated with these psychological diseases, and to identify a potential healthcare gap. METHODS: A total of 295 prosthetic eye wearers were screened using the 7-item generalized anxiety disorder scale (GAD-7) and the 9-item patient health questionnaire (PHQ-9). Scores of GAD-7 and PHQ-9 were correlated with scores of general physical and mental health functioning, vision-related quality of life, appearance-related distress, appearance-related social function, and further biosocial factors. RESULTS: Five patients (2%) had a pre-diagnosed anxiety disorder, and 20 patients (7%) had a pre-diagnosed depression. However, our screening revealed 26 patients (9%) with anxiety symptoms, 31 patients (11%) with depression symptoms, and 40 patients (14%) suffering from both anxiety and depression symptoms. This underdiagnosing for both anxiety and depression disorders was significant (p < 0.001, respectively). Higher GAD-7 scores were significantly associated with higher PHQ-9 scores, lower appearance-related social function, lower mental health functioning, and female gender (p ≤ 0.021, respectively). Higher PHQ-9 scores were significantly associated with lower physical and mental health functioning, higher educational degree, and non-traumatic eye loss (p ≤ 0.038, respectively). CONCLUSIONS:Anxiety and depression disorders seem to be underdiagnosed in prosthetic eye wearers and to have higher incidence compared with the general population. Therefore, a psychometric screening should be routinely implemented in the clinical care. For a successful long-term rehabilitation, integrated care by a multidisciplinary team including ophthalmic plastic surgeons, ophthalmologists, ocularists, general practitioners, and psychologists is essential.
Authors: Alexander C Rokohl; Marc Trester; Yongwei Guo; Werner Adler; Viktoria K Jaeger; Niklas Loreck; Joel M Mor; Keith R Pine; Ludwig M Heindl Journal: Ocul Surf Date: 2020-05-06 Impact factor: 5.033
Authors: Alexander C Rokohl; Konrad R Koch; Werner Adler; Marc Trester; Wolfgang Trester; Nicola S Pine; Keith R Pine; Ludwig M Heindl Journal: Graefes Arch Clin Exp Ophthalmol Date: 2018-03-03 Impact factor: 3.117
Authors: Alexander C Rokohl; Konrad R Koch; Marc Trester; Wolfgang Trester; Keith R Pine; Ludwig M Heindl Journal: Ophthalmic Plast Reconstr Surg Date: 2018 Jul/Aug Impact factor: 1.746
Authors: Siri Uppuluri; Aditya Uppuluri; Paul D Langer; Marco A Zarbin; Neelakshi Bhagat Journal: Graefes Arch Clin Exp Ophthalmol Date: 2022-03-16 Impact factor: 3.535
Authors: Alexander C Rokohl; Adam Kopecky; Marc Trester; Philomena A Wawer Matos; Keith R Pine; Ludwig M Heindl Journal: Graefes Arch Clin Exp Ophthalmol Date: 2022-04-02 Impact factor: 3.535