Depression, post-traumatic stress disorder, and dry eye syndrome: a study utilizing the national United States Veterans Affairs administrative database

Details

• Personal Author:
  Faler AL ; Feuer W ; Florez H ; Galor A ; Lee DJ ; Perez VL ; Zann KL
• Description:
  PURPOSE: To study the scope of dry eye syndrome (DES) in veterans on a national level and to evaluate the relationship between psychiatric diagnoses and DES. DESIGN: Case-control study. METHODS: Setting: Patients were seen in a Veterans Affairs (VA) eye clinic between 2006 and 2011. Patient population: Patients were divided into cases and controls with regard to their dry eye status (cases = ICD-9 code for DES plus dry eye therapy; controls = patients without ICD-9 code plus no therapy). Main outcome measures: The prevalence of DES and the influence of psychiatric diagnoses on the risk of DES. RESULTS: A total of 2 454 458 patients were identified as either a dry eye case (n = 462 641) or control (n = 1 991 817). Overall, 19% of male patients and 22% of female patients had a diagnosis of DES, with female sex imparting an increased risk of DES at each decade compared to male sex (odds ratio [OR] 1.22-2.09). Several conditions were found to increase DES risk, including post-traumatic stress disorder (OR 1.92, 95% CI 1.91-1.94) and depression (OR 1.92, 95% CI 1.91-1.94) (analyses adjusted for sex and age). The use of several systemic medications was likewise associated with an increased risk of DES, including antidepressant medications (OR 1.97, 95% CI 1.79-2.17) and antianxiety medication (OR 1.74, 95% CI 1.58-1.91). Multivariate analysis (adjusted for age and sex) revealed that for psychiatric diagnoses, both the use of medication and the diagnosis remained significant risk factors when considered concomitantly, although the magnitude of each association decreased. CONCLUSIONS: DES is a disease associated with depression and post-traumatic stress disorder, and is prevalent among male and female veterans receiving eye care services. The association could be driven by underlying disease physiology or medications used to treat psychiatric conditions. Regardless of the causal link, this suggests that individuals with a known psychiatric diagnosis should be questioned about dry eye symptoms and, if applicable, referred to an eye care physician. [Description provided by NIOSH]
• Subjects:
  Aging Case Reports Epidemiology Eye Diseases Men Mental Disorders Mental Health Occupational Health Risk Assessment Risk Factors Safety Women

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• Keywords:
  Age-groups Antidepressants Case-studies Eye-disorders Humans Mental-disorders Psychological-effects Psychology Risk-factors Statistical-analysis Stress

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• ISSN:
  0002-9394
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Florida ; OSHA Region 4 ; OSHA Region 8 ; Utah
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  340-346
• Volume:
  154
• Issue:
  2
• NIOSHTIC Number:
  nn:20041654
• Citation:
  Am J Ophthalmol 2012 Aug; 154(2):340-346
• Contact Point Address:
  Anat Galor, MD, 900 NW 17th St, Miami, FL 33136
• Email:
  agalor@med.miami.edu
• Federal Fiscal Year:
  2012
• Performing Organization:
  University of Miami School of Medicine
• Peer Reviewed:
  True
• Start Date:
  20020901
• Source Full Name:
  American Journal of Ophthalmology
• End Date:
  20130831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:1c4b186f2dcb415dce5e1351598911cc16886469128463143602d9c5dcd587751472889b4692f629da69259539f64d873543b36631b510b802777ca2dc23a83a
• Download URL:
  https://stacks.cdc.gov/view/cdc/194154/cdc_194154_DS1.pdf
• File Type:
  [PDF - 1.42 MB ]