Association Between Glaucoma and Mental Health Disorders Based on a Large National Database

To investigate the association between glaucoma and various mental health disorders and to examine whether there were indications of effect measure modification of this association in Black compared to Non-Black populations.

The study included 65,140 individuals from the Medical Expenditure Panel Survey database, with an in-depth focus on 15,016 patients suffering from glaucoma or specific mental health disorders. We included patients aged 18 and above diagnosed with glaucoma or specific mental health disorders based on International Classification of Diseases codes from 2017 to 2020.

Out of the 65,140 patients, 1492, 6359, 5756, 786, and 209 were diagnosed with glaucoma, anxiety, major depressive disorder (MDD), bipolar disorder, and schizophrenia, respectively. Of the 1492 glaucoma patients, 196 (13.2%) were diagnosed with anxiety, 183 (12.2%) with MDD, 20 (1.3%) with bipolar, and 15 (1%) with schizophrenia. The unadjusted OR (95% CI) was calculated for the association between glaucoma and anxiety (OR = 1.36 [1.17-1.58]) P $<$ 0.001), glaucoma and MDD (OR = 1.4 [1.20-164], P $<$ 0.001), glaucoma and bipolar (OR = 1.08 [0.69-1.6], P = 0.71), and glaucoma and schizophrenia and (OR = 3.08 [1.82-5.21], P $<$ 0.001). After adjustment for confounding factors, the association between glaucoma and anxiety, glaucoma and MDD, and glaucoma and schizophrenia remained statistically significant. Furthermore, for this association after interaction analysis, the interaction term of glaucoma and race with MDD (OR = 1.02 [0.6-1.5], P = 0.9), anxiety (OR = 0.64 [0.39-1], P = 0.069), and schizophrenia (OR = 2.8 [0.9-8.6], P = 0.9) didn't yield a significant evidence of effect measure modifications in Black compared to Non-Black groups after Bonferroni correction.

There was a statistically significant association between glaucoma and MDD, anxiety, and schizophrenia. However, for this association, there was no significant evidence of effect measure modifications in Black compared to Non-Black populations.