Risk factors for anxiety and depression in patients diagnosed with glaucoma at the Philippine General Hospital
Authors: Bell Christine Siguan , Florcruz Nilo Vincent D.G. 
Published: January 2021

Objective: The main objective of this study is to identify the risk factors associated with anxiety and depression among Filipino patients with glaucoma at a tertiary hospital in Manila. The study also aims to determine the sociodemographic profile of patients diagnosed with glaucoma based on age, sex, and social history. Additionally, the study seeks to determine the prevalence of anxiety and depression among Filipino glaucoma patients.

Methods: This is a single-center, cross-sectional study. The levels of anxiety and depression in 82 glaucoma patients, seen in a tertiary hospital in Manila, were evaluated using the Filipino version of the Hospital Anxiety and Depression Scale (HADS-P) questionnaire, which consists of two subscales, representing HADS-anxiety (HADS-A) and HADS-depression (HADS-D). The sociodemographic profile of the glaucoma patients was identified using percentages and frequency distribution. The prevalence of anxiety and depression among the participants was determined using percentages. To identify the risk factors for anxiety and depression, Pearson correlation and linear regression analysis were performed with the HADS-A and HADS-D subscores as dependent variables and demographic and clinical features as independent variables.

Results: After analyzing the data available, it was noted that HADS-A score ≥ 11 was present in 15% of cases, indicating anxiety among the glaucoma patients. Borderline cases of anxiety were observed in 20% (HADS-A score of 8-10), and 65% were normal, with HADS-A scores of ≤ 7. Clinically diagnosed (HADS-D score of ≥11) cases of depression were 1%, borderline cases (HADS-D 8-10) were 12%, and patients with normal HADS-D score were 87%. The linear regression analysis revealed the following results: a significant relationship between the HADS-A subscore and age (B = −0.07, p = 0.0129); a significant relationship between the logarithm of minimum angular resolution (logMAR) best corrected visual acuity (BCVA) of the worse eye and HADS-A subscore (B = 0.424, p = 0.086); and the mean deviation of the worse eye and HADS-A subscore (B = 0.078, p = 0.025). The linear regression analysis revealed the following statistically significant relationships: HADS-D subscores and age (B = −0.06, p = 0.0125); logMAR BCVA of the worse eye and HADS-D subscore (B = 0.541, p = 0.006); mean deviation of the worse eye and HADS-D subscore (B = 0.070, p = 0.016); and mean deviation of the better eye and HADS-D subscore (B = 0.097, p = 0.032).

Conclusion: This study shows that the prevalence of anxiety is higher than that of depression in patients with glaucoma. It can also be concluded that younger age is a risk factor for both anxiety and depression. The patient’s visual acuity in the worse eye and visual field severity are also risk factors for both anxiety and depression. It is therefore essential for physicians to be aware of the risk factors for anxiety and depression in patients with glaucoma and to provide glaucoma patients with appropriate psychological care, in addition to ophthalmological care, to prevent the development of these psychological conditions.