Illness uncertainty, anxiety, and depression in primary glaucoma and associated influencing factors

Glaucoma, a condition frequently linked to severe depression, anxiety, and sleep disturbances, affects treatment adherence while potentially compromising effectiveness.

To explore illness uncertainty (IU), anxiety, and depressive symptoms in primary glaucoma and to discuss underlying triggers.

We recruited 120 primary glaucoma cases between January 2022 and November 2023. The Mishel Uncertainty in Illness Scale (MUIS) and the Hospital Anxiety and Depression Scale (HADS) [include HADS-anxiety subscale (HADS-A) and HADS-depression subscale (HADS-D)] subscales, were used to assess IU and emotional distress (anxiety/depression), respectively. The MUIS-HADS subscale interrelationships were determined by Pearson correlation. IU-associated determinants were identified using univariate and binary logistic regression analyses.

The cohort showed a mean MUIS score of 79.73 ± 8.97, corresponding to a moderately high IU level. The HADS-A and HADS-D scores averaged 6.57 ± 3.89 and 7.08 ± 5.05 points, respectively, with 15.00% of participants showing anxiety symptoms and 24.17% exhibiting depressive signs. Significant positive connections were observed between MUIS and both HADS-A (r = 0.359, P < 0.001) and HADS-D (r = 0.426, P < 0.001). Univariate analysis revealed that disease duration, insomnia, monthly household income per capita, and the presence of comorbid chronic conditions were significantly associated with anxiety or depression. Multivariate analysis identified insomnia as a risk factor and higher monthly household income as a protective factor.

Patients with primary glaucoma experience moderate IU levels, generally low anxiety, and mild depression. Specifically, the anxiety and depression risks were 15.00% and 24.17%, respectively. A significant positive correlation existed between IU and anxiety/depression in these patients. Additionally, insomnia or lower monthly household income elevated anxiety/depression risks, enabling reliable anxiety/depression risk categorization among patients.