Association between myopia and anxiety: a cross-sectional study based on Chinese university freshmen

At least 1 billion people are affected by blindness or vision impairment worldwide, and in China, the proportion of myopia among college students is even higher. Anxiety and self-harm are becoming more and more common among college students, which indicates the importance of paying attention to their mental health. Previous studies have demonstrated that vision impairment has a negative impact on the mental health of adults. However, few studies have focused on the effects of myopia on college freshmen's mental health, and the association between the two factors in college students remained elusive.

This is a large cross-sectional study. A total of 5,519 college freshman would be assessed for the eligibility of the present study, and the inclusion criteria of this study were as follows: (I) first-year college student; (II) diagnosed as myopia and emmetropia through vision test; (III) gave informed consent. Five questionnaires were utilized to collect anxiety data, which include the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25), the Self Esteem Scale (SES), the Self Rating Anxiety Scale (SAS), the Self Rating Depression Scale (SDS), and the Social Avoidance and Distress Scale (SAD), for data collection. In addition, a socio-demographic questionnaire was designed and utilized to collect corresponding information. All enrollees were required to complete the all the above questionnaires.

In total 4,984 college students were enrolled. The proportion of males is 60.43%, and the mean age was 19.8 years old. Both right and left vision had a statistically significant association with NEI-VFQ-25 score (P=0.006, r=0.070; and P=0.021, r=0.060, respectively; Pearson correlation analysis) and SAS score (P=0.003, r=0.075 and P=0.004, r=0.075, respectively; Pearson correlation analysis). However, the correlation coefficient was very low (all less than 0.1). No significant correlation was observed between eye vision and other questionnaire scores.

Our data suggested that there is week correlation between myopia and anxiety. However, since this is a single-center study, the observed weak correlation may be caused by selection bias. Therefore, our results still need to be validated in further studies with a larger sample size.