Influence of visual acuity on suicidal ideation, suicide attempts and depression in South Korea.
BACKGROUND
To assess the influence of visual acuity (VA) on suicidal ideation, suicide attempts and depression.


METHODS
From 2008 to 2012, a total of 28 919 nationally representative participants aged 19 years or older in the Korea National Health and Nutrition Examination Survey underwent additional ophthalmological examinations by the Korean Ophthalmologic Society. Associations between best corrected VA in the better-seeing eye based on decimal fraction and mental health were identified using multivariable logistic regression analysis after adjusting for possible biopsychosocial confounders. Self-reported mental health (suicidal ideation, suicide attempt and depression), Euro Quality of Life-Visual Analog Scale and counselling experience were evaluated by direct interviews. A nomogram for risk of suicidal ideation was generated.


RESULTS
By multivariable logistic regression analysis, low VA was significantly associated with suicidal ideation and suicide attempt but not depression. Participants with a VA of no light perception to 0.2 had a nearly twofold and threefold increased risk of suicidal ideation (adjusted OR, 1.85; 95% CI 1.04 to 3.27) and suicidal attempt (adjusted OR, 3.44; 95% CI 0.92 to 12.79), compared with participants with a VA of 1.0. Sociodemographic disparities, including age and socioeconomic status, existed for suicidal ideation, suicidal attempt and depression. Euro Quality of Life-Visual Analog Scale significantly decreased as VA decreased and was lower in participants who attempted suicide.


CONCLUSIONS
Low VA was associated with the occurrence of suicidal ideation or a suicide attempt. Ophthalmologists should embrace their responsibility to help reduce suicidality and prevent suicides in patients with low VA by encouraging them to seek psychiatric care.
Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
Tyler Hyungtaek
TH
Rim
Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
Christopher Seungkyu
CS
Lee
Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
Sung Chul
SC
Lee
Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
Byunghoon
B
Chung
Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea Yonsei healthcare Big Data based Knowledge Integration System Research Center, Yonsei University College of Medicine, Seoul, Korea Institute of Convergence Science, Yonsei University College of Medicine, Seoul, Korea.
Sung Soo
SS
Kim
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D003866:Depressive Disorder / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009749:Nutrition Surveys; D011788:Quality of Life; D056910:Republic of Korea / Q000453:epidemiology; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014792:Visual Acuity / Q000502:physiology*; D064232:Visual Analog Scale; D055815:Young Adult
Epidemiology; Vision