title: Emotional distress in patients with retinal disease.
abstract: OBJECTIVE
  To investigate the prevalence of, and potential risk factors for, emotional distress among patients with retinal disease.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Cases consisted of 86 consecutive patients at Wilmer Eye Institute Retinal Vascular Center. Fifty-one controls with normal visual acuity and no known ocular disease were frequency-matched to the cases by age, sex, and race. Subjects were interviewed using the Community Disability Scale, a functional status questionnaire, and the General Health Questionnaire, a questionnaire assessing emotional distress.
  
  
  RESULTS
  The prevalence of probable (General Health Questionnaire score 4 or greater and less than 10) or definite (General Health Questionnaire score 10 or greater) emotional distress was 59.3% among ophthalmic patients and 2.0% among controls. There were significant relationships between emotional distress, as assessed by General Health Questionnaire score, and degree of 1) visual impairment, as assessed by weighted bilateral average logarithm of minimal angle of resolution (logMAR), and 2) functional impairment, as assessed by Community Disability Scale score (P =.001). Univariate analyses identified significant predictors of emotional distress: shorter duration of ocular disease (P =.019), worse visual acuity (P =.001), increased systemic comorbidities (P =.001), and increased functional impairment (P <.001). Multiple regression analysis demonstrates that worse visual acuity, increased systemic comorbidities, and shorter duration of ocular disease each explain over 10% of the variability in General Health Questionnaire score (r(2) = 0.15, 0.12, and 0.11, respectively). Addition of Community Disability Scale score to the regression model eliminates the significance of visual acuity and systemic comorbidities; Community Disability Scale score explains nearly 30% of the variability in emotional distress, as assessed by General Health Questionnaire score (r(2) = 0.29).
  
  
  CONCLUSIONS
  Emotional distress is prevalent among patients with retinal disease; potential risk factors for emotional distress among such patients include shorter duration of ocular disease, worse visual acuity, increased systemic comorbidities, and increased functional impairment.
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Florida 33101, USA. iscott@bpei.med.miami.edu
authors.forename: I U
authors.initials: IU
authors.lastname: Scott
authors.forename: O D
authors.initials: OD
authors.lastname: Schein
authors.forename: W J
authors.initials: WJ
authors.lastname: Feuer
authors.forename: M F
authors.initials: MF
authors.lastname: Folstein
authors.forename: K
authors.initials: K
authors.lastname: Bandeen-Roche
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008396:Maryland / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012164:Retinal Diseases / Q000150:complications* / Q000453:epidemiology; D012307:Risk Factors; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology*; D011795:Surveys and Questionnaires; D014792:Visual Acuity