title: Dry eye disease, dry eye symptoms and depression: the Beijing Eye Study.
abstract: OBJECTIVE
  To investigate the association between dry eye symptoms and depression in an adult population.
  
  
  METHODS
  In this population-based cross-sectional study, a random sample of 1957 subjects from the Beijing Eye Study was examined for dry eye disease (DED) in 2006. All patients completed an interviewer-assisted questionnaire on dry eye symptoms and underwent measurement of tear break-up time (TBUT), slit-lamp evaluation of corneal staining and meibomian gland dysfunction (MGD), and the Schirmer test. In 2011, 1456 subjects from this sample were evaluated for depression using a depression scale. The association between depression symptoms and dry eye clinical tests was evaluated.
  
  
  RESULTS
  Definite depression was more prevalent in patients with DED than in subjects without DED (13.7±0.4% vs 8.6±0.3%, p=0.02). The depression score was correlated with dry eye symptoms (correlation coefficient r=0.07; p=0.013) but not with TBUT (p=0.18), the Schirmer test (p=0.37), corneal staining (p=0.30) and MGD evaluation (p=0.93). In multivariate regression analysis, the risk of definite depression remained significantly associated with dry eye symptoms (p=0.028) after adjusting for lower cognitive status (p=0.01), rural region of habitation (p=0.023) and lower body weight (p=0.05).
  
  
  CONCLUSIONS
  In an older population from Beijing, depression was associated with DED and in particular with dry eye symptoms.
authors.affiliation: Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, , Beijing, China.
authors.forename: Antoine
authors.initials: A
authors.lastname: Labbé
authors.forename: Ya Xing
authors.initials: YX
authors.lastname: Wang
authors.forename: Ying
authors.initials: Y
authors.lastname: Jie
authors.forename: Christophe
authors.initials: C
authors.lastname: Baudouin
authors.forename: Jost B
authors.initials: JB
authors.lastname: Jonas
authors.forename: Liang
authors.initials: L
authors.lastname: Xu
mesh_terms: D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D003941:Diagnostic Techniques, Ophthalmological; D015352:Dry Eye Syndromes / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011594:Psychometrics / Q000379:methods; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
keywords: Epidemiology; Ocular surface