The relationship between diabetic retinopathy and psychosocial functioning: a systematic review

Area of Science:

• Ophthalmology
• Psychiatry
• Public Health

Background:

• Diabetic retinopathy/diabetic macular edema (DR/DME) is a leading cause of vision loss.
• Previous research suggests a link between DR/DME and psychosocial functioning, but the exact nature of this relationship is unclear.

Purpose of the Study:

• To systematically review and determine the relationship between DR/DME and various aspects of psychosocial functioning.
• To explore the directionality of this association, including emotional and social well-being, depression, anxiety, and distress.

Main Methods:

• A systematic search of major databases (PubMed, Embase, Medline, Cochrane Central) was conducted.
• Included were interventional and observational quantitative studies assessing DR/DME and psychosocial functioning.
• Study quality was assessed using standardized checklists (Newcastle-Ottawa, Down's and Black).

Main Results:

• 42 studies were included, comprising observational and interventional designs.
• DR/DME severity and vision impairment were consistently associated with poorer psychosocial outcomes, including depression.
• Depression at baseline was linked to increased DR incidence and progression; interventions improved psychosocial outcomes.

Conclusions:

• The severity of DR/DME and associated vision loss significantly correlate with adverse psychosocial outcomes.
• A bi-directional relationship exists between depression and DR/DME, where depression can exacerbate DR progression.
• Targeted interventions for DR/DME progression and improved psychological screening/care are recommended.