Observational Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatr. Jun 19, 2020; 10(6): 139-149
Published online Jun 19, 2020. doi: 10.5498/wjp.v10.i6.139
Visual impairment and depression: Age-specific prevalence, associations with vision loss, and relation to life satisfaction
Audun Brunes, Trond Heir
Audun Brunes, Trond Heir, Section for Trauma, Catastrophes and Forced Migration - Adults and Elderly, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo NO-0484, Norway
Trond Heir, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, NO-0315, Norway
Author contributions: Brunes A contributed to data analysis, interpretation, writing the article, and formatting; Heir T contributed to study conception, study design, data analysis, interpretation, writing, and final approval of article.
Supported by the European Commission, Directorate-General for European Civil Protection and Humanitarian Aid Operations, No. ECHO/SUB/2015/718665/PREP17; and the Norwegian Association of the Blind and Partially Sighted, No. S23/2017, No. S20/2018 and No. S12/2019.
Institutional review board statement: The Regional Committee for Medical and Health Research Ethics gave permission to carry out the study in accordance with procedures for anonymized data (Reference number: 2016/1615A).
Informed consent statement: All participants gave their informed consent to take part in the study.
Conflict-of-interest statement: No potential conflict of interest was reported by the authors.
Data sharing statement: Data are from the research project European Network for Psychosocial Crisis Management – Assisting Disabled in Case of Disaster (EUNAD). Public availability may comprise the privacy of the participants. According to the informed consent given by each participant, the data are to be stored properly and in line with EU Regulation 2017/679 (General Data Protection Regulation (GDPR)). However, anonymized data is available to researchers who provide a methodologically sound proposal in accordance with the informed consent of the participants. Interested researchers can contact project leader Trond Heir (trond.heir@medisin.uio.no) with a request for our study data.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised in accordance with the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Audun Brunes, PhD, Research Scientist, Section for Trauma, Catastrophes and Forced Migration - Adults and Elderly, Norwegian Centre for Violence and Traumatic Stress Studies, PB 181 Nydalen, Oslo NO-0409, Norway. audun.brunes@nkvts.no
Received: January 31, 2020
Peer-review started: January 31, 2020
First decision: March 24, 2020
Revised: May 18, 2020
Accepted: May 21, 2020
Article in press: May 21, 2020
Published online: June 19, 2020
Abstract
BACKGROUND

To our knowledge, no study has obtained specific estimates of depression for young and middle-aged adults with visual impairment (VI). As estimates of depression varies across age groups in the general population, it is of interest to examine whether the same applies to adults with low vision or blindness.

AIM

To estimate depression prevalence and its association with VI-related characteristics and life satisfaction in adults with VI.

METHODS

A telephone-based cross-sectional survey was conducted between January and May 2017 in an age-stratified sample of adults who were members of the Norwegian Association of the Blind and Partially Sighted. Participants were asked questions about their sociodemographic characteristics, VI characteristics, and life satisfaction. Depression was measured with the Patient Health Questionnaire. The diagnostic scoring algorithm was used to calculate the point prevalence of depression (i.e., major depression and other depressive disorders) across categories of gender and age (years: 18-35, 36-50, 51-65, ≥ 66). The associations were estimated using regression models.

RESULTS

Overall, 736 adults participated in the study (response rate: 61%). The prevalence estimates of depression varied across different age groups, ranging from 11.1%-22.8% in women and 9.4%-16.5% in men, with the highest rates for the two youngest age groups. Results from the multivariable models including sociodemographic and VI-related variables showed that losing vision late in life [Prevalence ratio (PR), 1.76, 95%CI: 1.11, 2.79] and having other impairments (PR: 1.88, 95%CI: 1.32, 2.67) were associated with higher rates of depression, whereas older age was associated with lower rates (PR: 0.83, 95%CI: 0.74, 0.93). Additionally, participants who were depressed had lower life satisfaction than those who were not depressed (adjusted β: -2.36, 95%CI: -2.75, -1.98).

CONCLUSION

Our findings suggest that depression in adults with VI, and especially among young and middle-aged adults, warrants greater attention by user organisations, clinicians, and healthcare authorities.

Keywords: Blindness, Depression, Life satisfaction, Major depression, Vision loss, Visual impairment

Core tip: Depression in people with visual impairment (VI) goes often unrecognized and untreated, yet knowledge about its occurrence can help to inform the design of mental health services targeting the specific population. The study’s findings of a high rate of depressive disorders in adults with VI, particularly among young and middle-aged adults, should in part be interpreted in the light of the extensive stigma, discrimination, isolation, and loneliness that they experience. For depressed adults with VI, the consequences may be severe in terms of a lower quality of life.