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Dry Eye Disease in Patients With Depressive and Anxiety Disorders in Shanghai

Wen, Wen MD; Wu, Yanru MD, PhD; Chen, Yuhong MD, PhD; Gong, Lan MD, PhD; Li, Meiyan MD; Chen, Xueli MD, PhD; Yan, Manni MD; Xiao, Zeping MD, PhD; Sun, Xinghuai MD, PhD

doi: 10.1097/ICO.0b013e3182261590
Basic Investigation

Purpose: To investigate dry eye disease (DED) and risk factors in patients with depressive or anxiety disorders at a psychiatric clinic in China.

Methods: Cross-sectional study. Subjects (≥16 years) who had depressive or anxiety disorders were evaluated with history, questionnaires (Self-rating Anxiety Scale, Self-rating Depression Scale, and Ocular Surface Disease Index), and eye examination.

Results: There were 472 psychiatric patients in the study, including 176 patients (37%) with depression, 170 patients (36%) with generalized anxiety disorder, 60 patients (13%) with depression and anxiety disorder, 55 patients (12%) with obsessive–compulsive disorder, and 11 patients (2%) with panic disorder. DED was present in 283 patients (60%). Compared with patients who did not have DED, patients with DED were significantly older, had longer duration of psychiatric disease and use of antianxiety or antidepressant medication, and more frequently were using a selective serotonin reuptake inhibitor (SSRI). Logistic regression analysis showed that older age, duration of psychiatric disorder, and use of an SSRI were significant independent predictors of the presence of DED. Older age, Self-rating Anxiety Scale >52, and use of tricyclic antidepressants were significant independent predictors of worse vision-targeted health-related quality of life (higher Ocular Surface Disease Index).

Conclusions: DED is frequent in patients with depressive and anxiety disorders, especially patients who are older, have longer duration of psychiatric disorder, and use an SSRI. Psychiatric disorders and use of antidepressants should be considered in the differential diagnosis of DED.

*Department of Ophthalmology and Vision Science, Eye and Ear Nose Throat Hospital, Fudan University, Shanghai, China

Psychosomatic Department, Shanghai Mental Center, Shanghai Jiaotong University, Shanghai, China

State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, Shanghai, China.

W. Wen and Y. Wu contributed equally to this work, and Z. Xiao and X. Sun contributed equally to this work.

This study was sponsored by the Program of Shanghai Subject Chief Scientist (08XD14011), a government-sponsored program.

The authors declare no conflicts of interest.

Reprints: Xinghuai Sun, Department of Ophthalmology and Vision Science, Eye and Ear Nose Throat Hospital, Fudan University, 83 Fenyang Rd, Shanghai 200031, China (e-mail:

Received March 19, 2011

Accepted May 24, 2011

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.