title: Identifying distinct risk factors for vision-specific distress and depressive symptoms in people with vision impairment.
abstract: OBJECTIVE
  To determine the relative importance and associated risk factors of vision-specific distress and depressive symptoms in people with visual impairments.
  
  
  METHODS
  In this cross-sectional study, 162 adult patients with visual acuity less than 6/12 were interviewed using telephone-administered questionnaires. Vision-specific distress was assessed with the emotional well-being scale of the Impact of Vision Impairment Questionnaire. Depressive symptoms were assessed with the Patient Health Questionnaire-9. Other measures including vision-specific functioning, coping, and social support were also assessed. Multiple regression and commonality analysis were used to determine the relative contribution of factors explaining variance in vision-specific distress and depressive symptoms.
  
  
  RESULTS
  Vision-specific distress and depressive symptoms were strongly associated. Vision-specific functioning (βs = 0.47, P < 0.001), avoidant coping (βs = -0.32, P < 0.001), social coping efficacy (βs = -0.17, P = 0.001), and depressive symptoms (βs = 0.18, P = 0.006) were significant determinants of vision-specific distress. Vision-specific functioning accounted for 37.7% of the unique variance in this model. Vision-specific distress was an important risk factor for depression, accounting for 36.6% of the unique variance in depressive symptoms.
  
  
  CONCLUSIONS
  Vision-specific distress is related to a person's ability to manage the practical and social challenges of vision impairment. Further work is required to distinguish vision-specific distress and depression and to examine what interventions are best to target vision-specific distress.
authors.affiliation: Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Australia.
authors.forename: Gwyneth
authors.initials: G
authors.lastname: Rees
authors.forename: Jing
authors.initials: J
authors.lastname: Xie
authors.forename: Edith E
authors.initials: EE
authors.lastname: Holloway
authors.forename: Bonnie A
authors.initials: BA
authors.lastname: Sturrock
authors.forename: Eva K
authors.initials: EK
authors.lastname: Fenwick
authors.forename: Jill E
authors.initials: JE
authors.lastname: Keeffe
authors.forename: Ecosse
authors.initials: E
authors.lastname: Lamoureux
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014739:Victoria / Q000453:epidemiology; D015354:Vision, Low / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D014792:Visual Acuity
keywords: coping; depression; low vision; social support; vision-specific distress; visual impairment