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Incidence and Prevalence of Depression, Anxiety, and Suicidal Ideation in Patients with Uveitis and Scleritis in the
Rajit Agarwal1, Daniel Lee1, Israel Mendez Bermudez2
1College of Medicine, Drexel University, Philadelphia, Pennsylvania, USA.
Purpose:
To evaluate the incidence and prevalence of depression, anxiety, and suicidal ideation (SI) in patients with uveitis and scleritis in the TriNetX US Collaborative Network.
Methods:
A retrospective study was conducted using ICD-10 codes to identify patients with uveitis and scleritis who were then diagnosed with depression, anxiety, or SI. Yearly and cumulative incidences and prevalences (2013-2023) of depression, anxiety, and SI were determined along with risk ratios for these conditions in patients with glaucoma, low vision, cataracts, macular edema, and systemic corticosteroid usage.
Results:
Of 97,616,995 patients in the database, 205,193 (0.24%) were diagnosed with uveitis and 29,270 with scleritis (0.029%). The cumulative incidences of depression, anxiety, and SI were 3,927; 4,936; and 457 per 100,000 patients with uveitis and 3,792; 5,064; and 357 per 100,000 patients with scleritis, respectively. Risk ratios demonstrated significant association between uveitis and depression (1.78, 1.76-1.80, p < 0.05), anxiety (1.61, 1.59-1.62, p < 0.05), and SI (1.33, 1.28-1.37, p < 0.05). The highest subgroup risks appeared in uveitis with glaucoma and depression (1.59, 1.55-1.62, p < 0.05) and scleritis with glaucoma and depression (1.47, 1.37-1.60, p < 0.05). Risk ratios also showed a decreased risk of depression and anxiety in uveitis patients compared to patients with type 2 diabetes mellitus and rheumatoid arthritis.
Conclusion:
There is increased risk of depression, anxiety, or SI in patients with uveitis or scleritis, including those with ocular complications or those prescribed systemic corticosteroids. These data highlight the need for physicians to consider a psychiatric review of systems into clinic visits for treatment of ocular inflammatory conditions.
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