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
Research background

People with visual impairment (VI) may be at risk of depression, but previous studies have demonstrated inconsistent results and have either reported extremely low rates or reported rates that ranged as high as 60%. Furthermore, previous studies of depression have mainly been restricted to older people or to specific subgroups of the population.

Research motivation

Depression in this population goes often unrecognized and untreated. We have yet to fully understand the magnitude of the problem and who is at particular risk of developing depression. By obtaining more precise knowledge about the age-specific prevalence and associated factors of depression, this information can be valuable in the design of preventive efforts and to anticipate service needs.

Research objectives

We conducted a large, age-stratified study in the adult population of people with low vision or blindness, with the following three main aims: (1) To estimate the point prevalence of depressive disorders in stratified age groups of adults with VI; (2) To examine whether depression was associated with different characteristics of vision loss; and (3) And to describe the association between depression and life satisfaction. By doing so, we hoped to examine and better understand the age-specific risk of depression among people with VI, as well as its associated factors and potential consequences on people’s quality of life.

Research methods

The study was conducted as a cross-sectional interview-based survey between January and May 2017 and included an age-stratified sample of adults with VI. All participants were recruited through the members list of the Norwegian Association of the Blind and Partially Sighted. A total of 736 (61%) adults participated by completing the interview.

Research results

The prevalence of depression in different age groups varied from 11.1%-22.8% in women to 9.4%-16.5% in men. The estimates were highest in the two youngest age groups, and these rates were two times higher than those presented in previous studies of Westernized populations. Additionally, we found that depression was independently associated with having other impairments and loss of vision late in life, indicating that having difficulties in adapting to a new situation of being visually impaired or blind may put people at increased risk of developing depression. Lastly, depressed people in our study sample had considerably lower life satisfaction and were more likely to be referred for psychological counselling than were people without depression. The themes most often brought up by the participants during their consultations with the psychologist were related to problems with minority stress and handling stigma. We therefore argue that the high rates of depression in people with VI should be viewed in terms of stigma, discrimination, loneliness, and isolation.

Research conclusions

To our knowledge, our study is the first to provide estimates of depression for the youngest part of the adult VI population. We have identified some subgroups of the population at greater risk of depression than others. Because of the high depression rates and their strong associations with quality of life, we recommend the initiation of efforts that would improve access to professionals trained in the needs and challenges of people with VI.

Research perspectives

Our research findings should be supported by future studies that include a large probability sample of the entire adult VI population and that diagnose depression through clinical interviews. Moreover, future research should involve measures of modifiable risk factors of depression so that effective interventions can be designed to reduce the burden of depression for this population.