Anxiety and depression prevalence rates in age-related macular degeneration.
OBJECTIVE
To estimate the prevalence rates of depression and anxiety in patients with wet age-related macular degeneration (AMD) and the relationship with visual acuity and to develop a simple algorithm for depression screening.


METHODS
This cross-sectional, prospective, observational, multicenter study was performed in France, Germany, and Italy. Retina specialists at 10 centers per country each enrolled 12 consecutive patients with wet ARMD. Patients were stratified into four severity groups by using best eye (BE) and worst eye (WE) visual acuity (VA) thresholds (BE:VA 20/40 and WE:VA 20/200). Patients rated themselves on the Hospital Anxiety and Depression Scale (HADS). Analysis of variance was performed to estimate the effect of VA severity levels on HADS scores adjusted on age, gender, and country.


RESULTS
Patients (females 60%) were recruited, with a mean age of 77 years and 2.3 years' disease duration. Mean BE:VA at inclusion was 0.49 logMar (logarithm of the minimum angled of resolution) and WE:VA 1.0 logMar. The prevalence of severe depression increased from 0% (BE:VA > or = 20/40+WE:VA > or = 20/200) to 7.6% (BE:VA < 20/40+WE:VA < 20/200), whereas anxiety was unrelated to VA loss. Moreover, total depression scores were strongly associated with VA severity (P = 0.006), but not total anxiety scores (P = 0.840). Responses to two HADS items ("I still enjoy things I used to enjoy"; "I can enjoy a good book or radio or television program") identified 95% of severely to moderately depressed patients.


CONCLUSIONS
Self-rated depression in patients with AMD was associated with VA severity level. It should, therefore, be relatively easy for ophthalmologists to implement the screening procedure and refer identified patients to psychiatrists for proper assessment and treatment.
Augustin
Albert
A
Augenklinik, Karlsruhe, Germany.
Sahel
José-Alain
JA
Bandello
Francesco
F
Dardennes
Roland
R
Maurel
Frédérique
F
Negrini
Cristina
C
Hieke
Klaus
K
Berdeaux
Gilles
G
D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D005602:France / Q000453:epidemiology; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008268:Macular Degeneration / Q000453:epidemiology*; D008297:Male; D010556:Personality Tests; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D014792:Visual Acuity