title: Patients with blepharitis are at elevated risk of anxiety and depression.
abstract: OBJECTIVE
  Population-based cohort study on the risk of anxiety and depression in patients with blepharitis is limited. This study evaluated whether blepharitis patients are at a higher risk of anxiety and depression.
  
  
  METHODS
  A retrospective cohort study.
  
  
  METHODS
  We used the universal insurance claims data from 1997 to 2010 in Taiwan to identify annually patients with newly diagnosed blepharitis (N = 9764) and without the disease (N = 39056). Incidences, rate ratios (IRR) and hazard ratios (HR) of anxiety and depression were measured for both cohorts by baseline demographic characteristics and comorbidities until the end of 2010.
  
  
  RESULTS
  Compared with the non-blepharitis cohort, the blepharitis cohort had higher incidence of anxiety (15.9 vs. 9.5 per 1000 person-years), with an adjusted HR of 1.58 (95% confidence interval (CI) = 1.46-1.70). The incidence of depression was also higher in the blepharitis cohort (7.66 vs. 5.05 per 1000 person-years), with an adjusted HR of 1.42 (95% CI = 1.28-1.58). The blepharitis cohort to the non-blepharitis cohort IRR decreased from 1.73 in the first quartile to 1.32 in the 4(th) quartile for anxiety, and from 1.67 to 1.29 for depression.
  
  
  CONCLUSIONS
  Patients with blepharitis are at elevated risks of anxiety and depression. The risk is higher in earlier period after the diagnosis of blepharitis, and declines by time, but remains significantly higher for those with blepharitis than those without blepharitis.
authors.affiliation: Department of Ophthalmology, China Medical University Hospital, Taichung, Taiwan ; School of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Chun-Chi
authors.initials: CC
authors.lastname: Chiang
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.affiliation: Department of Ophthalmology, China Medical University Hospital, Taichung, Taiwan ; School of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Yi-Yu
authors.initials: YY
authors.lastname: Tsai
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Chiao-Ling
authors.initials: CL
authors.lastname: Peng
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Ya-Tang
authors.initials: YT
authors.lastname: Liao
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan ; Department of Public Health, China Medical University College of Public Health, Taichung, Taiwan.
authors.forename: Fung-Chang
authors.initials: FC
authors.lastname: Sung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology* / Q000209:etiology*; D001762:Blepharitis / Q000150:complications*; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012306:Risk; D055815:Young Adult