Dry eye disease in patients with depressive and anxiety disorders in Shanghai

To investigate dry eye disease (DED) and risk factors in patients with depressive or anxiety disorders at a psychiatric clinic in China.

Cross-sectional study. Subjects (≥16 years) who had depressive or anxiety disorders were evaluated with history, questionnaires (Self-rating Anxiety Scale, Self-rating Depression Scale, and Ocular Surface Disease Index), and eye examination.

There were 472 psychiatric patients in the study, including 176 patients (37%) with depression, 170 patients (36%) with generalized anxiety disorder, 60 patients (13%) with depression and anxiety disorder, 55 patients (12%) with obsessive-compulsive disorder, and 11 patients (2%) with panic disorder. DED was present in 283 patients (60%). Compared with patients who did not have DED, patients with DED were significantly older, had longer duration of psychiatric disease and use of antianxiety or antidepressant medication, and more frequently were using a selective serotonin reuptake inhibitor (SSRI). Logistic regression analysis showed that older age, duration of psychiatric disorder, and use of an SSRI were significant independent predictors of the presence of DED. Older age, Self-rating Anxiety Scale >52, and use of tricyclic antidepressants were significant independent predictors of worse vision-targeted health-related quality of life (higher Ocular Surface Disease Index).

DED is frequent in patients with depressive and anxiety disorders, especially patients who are older, have longer duration of psychiatric disorder, and use an SSRI. Psychiatric disorders and use of antidepressants should be considered in the differential diagnosis of DED.