title: Vision-specific distress and depressive symptoms in people with vision impairment.
abstract: OBJECTIVE
  To determine the unique contribution of vision-specific distress in predicting depressive symptoms in people with vision impairment attending a tertiary eye care clinic.
  
  
  METHODS
  In this cross-sectional study, interview-administered surveys were conducted with 143 adult patients who had presenting visual acuity <0.3 logMAR. Depressive symptoms were assessed with the Patient Health Questionnaire-9 and vision-specific distress was assessed with the Impact of Vision Impairment (IVI) Questionnaire emotional well-being subscale. In addition, level of restriction of participation in common daily activities due to vision impairment was assessed with the IVI and measures of general physical health and social support were included.
  
  
  RESULTS
  Twenty-one (14.7%) of 143 participants reported clinically significant depressive symptoms and an additional 27.3% (n = 39) had mild depressive symptoms. Vision-specific distress was the strongest unique predictor of depressive symptoms (beta = 0.37, P < 0.001), with physical health (beta = -0.22, P < 0.01), age (beta = -0.18, P < 0.05), and experience of a negative life event (beta = 0.15, P < 0.05) also contributing significantly to depressive symptoms. Results also indicated that vision-specific distress mediates the impact of participation restriction due to vision impairment on depressive symptoms.
  
  
  CONCLUSIONS
  An assessment of vision-specific distress may be a useful tool with which to identify those at risk of depression or in need of early intervention in eye care or rehabilitation settings. Depression treatment approaches or depression prevention strategies for people with vision impairment may benefit from a focus on vision-specific distress.
authors.affiliation: Centre for Eye Research Australia, the Royal Victorian Eye and Ear Hospital, University of Melbourne, East Melbourne, VIC, Australia. grees@unimelb.edu.au
authors.forename: Gwyneth
authors.initials: G
authors.lastname: Rees
authors.forename: Hui Wen
authors.initials: HW
authors.lastname: Tee
authors.forename: Manjula
authors.initials: M
authors.lastname: Marella
authors.forename: Eva
authors.initials: E
authors.lastname: Fenwick
authors.forename: Mohamed
authors.initials: M
authors.lastname: Dirani
authors.forename: Ecosse L
authors.initials: EL
authors.lastname: Lamoureux
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014786:Vision Disorders / Q000175:diagnosis* / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology; D019987:Persons with Visual Disabilities; D055815:Young Adult