title: Dry Eye Disease in Patients with Newly Diagnosed Depressive Disorder.
abstract: Psychiatric conditions and not just the treatments themselves might be involved in the pathophysiology of dry eye disease (DED). The aim of our study was to evaluate the association between depression and DED using objective and subjective tests in patients with newly diagnosed depressive disorder who were not using any medication which may help us to determine the sole effect of depression on dry eye.
  
  
  
  Thirty-six patients from the psychiatry clinic with a new diagnosis of depressive disorder and 32 controls were included in the study. All met the Diagnostic and Statistical Manual IV criteria for depression. Beck Depression Inventory (BDI) was used to measure depression severity and the State-Trait Anxiety Inventory (Stai1, Stai2) for concomitant anxiety symptoms. The Ocular Surface Disease Index (OSDI) and Visual Functioning Questionnaires (VFQ25) were completed and used to confirm diagnosis of DED in conjunction with the tear break up time (TBUT), ocular surface vital dye staining, and Schirmer's test.
  
  
  
  The comparison of depressive and control groups revealed significantly lower Schirmer (20.3 ± 9.9 vs. 25.7 ± 9.3 mm) and TBUT (7.8 ± 5.7 vs. 12.5 ± 7.8 s) scores with a consistently higher Oxford score (1.8 ± 3.2 vs. 0.2 ± 0.4) in the depressive group. Although the parameters were affected in the depressive group, this did not influence OSDI (86.1 ± 13.6 vs. 86.6 ± 13.3) and VFQ25 (30.8 ± 21.6 vs. 38.5 ± 29.1) scores. In both groups, the three psychological test scores (Stai1-2 and BDI) were correlated to each other but none of these tests were correlated to OSDI, VRQL, Schirmer, TBUT, and Oxford staining scores.
  
  
  
  Our study shows a definite association between depression and DED. We feel that it is important that psychiatrists take this into account especially while prescribing antidepressants which may aggravate dry eye signs.
authors.affiliation: a Ophthalmology Department , Balıkesir University School of Medicine , Balikesir , Turkey.
authors.forename: Nesime Setge
authors.initials: NS
authors.lastname: Tiskaoglu
authors.affiliation: a Ophthalmology Department , Balıkesir University School of Medicine , Balikesir , Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Yazıcı
authors.affiliation: b Psychiatry Department , Balıkesir University School of Medicine , Balikesir , Turkey.
authors.forename: Tunay
authors.initials: T
authors.lastname: Karlıdere
authors.affiliation: a Ophthalmology Department , Balıkesir University School of Medicine , Balikesir , Turkey.
authors.forename: Esin
authors.initials: E
authors.lastname: Sari
authors.affiliation: b Psychiatry Department , Balıkesir University School of Medicine , Balikesir , Turkey.
authors.forename: Elif Yilmaz
authors.initials: EY
authors.lastname: Oguz
authors.affiliation: c Ophthalmology Department , Sakarya Government Hospital , Sakarya , Turkey.
authors.forename: Musa
authors.initials: M
authors.lastname: Musaoglu
authors.affiliation: d Anatomy Department , Balikesir University School of Medicine , Balikesir , Turkey.
authors.forename: Seyda
authors.initials: S
authors.lastname: Aslan
authors.affiliation: a Ophthalmology Department , Balıkesir University School of Medicine , Balikesir , Turkey.
authors.forename: Sıtkı
authors.initials: S
authors.lastname: Samet Ermiş
mesh_terms: D000328:Adult; D003866:Depressive Disorder / Q000150:complications* / Q000175:diagnosis; D015352:Dry Eye Syndromes / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015995:Prevalence; D011594:Psychometrics / Q000379:methods*; D011795:Surveys and Questionnaires; D013666:Tears / Q000378:metabolism*; D014421:Turkey / Q000453:epidemiology
keywords: Dry eye disease (DED); Schirmer; depression; tear break up time (TBUT)