Evaluation of Quality of Life and Emotional Disturbances in Patients with Diabetic Retinopathy
-
Published:2023-11-03
Issue:11
Volume:13
Page:2516-2528
-
ISSN:2254-9625
-
Container-title:European Journal of Investigation in Health, Psychology and Education
-
language:en
-
Short-container-title:EJIHPE
Author:
Saitakis George1, Roukas Dimitrios2ORCID, Hatziagelaki Erifili3, Efstathiou Vasiliki4, Theodossiadis Panagiotis1, Rizos Emmanouil4ORCID
Affiliation:
1. Second Department of Ophthalmology, National and Kapodistrian University of Athens, ‘Attikon’ University General Hospital, 12462 Athens, Greece 2. Department of Psychiatry, 417 VA (NIMITS) Hospital, 11521 Athens, Greece 3. Research Institute and Diabetes Center, Second Department of Internal Medicine-Propaedeutic, National and Kapodistrian University of Athens, ‘Attikon’ University General Hospital, 12462 Athens, Greece 4. Second Department of Psychiatry, National and Kapodistrian University of Athens, Medical School of Athens, ‘Attikon’ University General Hospital, 12462 Athens, Greece
Abstract
Diabetes has detrimental effects on many organs, including the kidneys, heart, and the central nervous system, with ophthalmic involvement and Diabetic Retinopathy (DR), specifically, being among the most severe and prominent consequences. Diabetic Retinopathy and especially advanced stages of the disease, have a crucial impact on patients’ quality of life and emotional status. In this context, emotional imbalance, psychological side effects and comorbidities, like anxiety disorders, could emerge, deteriorating the patients’ condition further. A number of questionnaires can be employed in the evaluation of the potential impact of Diabetic Retinopathy on patients’ quality of life, including the Beck Anxiety Inventory (BAI) and The National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25). Purpose: The purpose of this study was to evaluate the association of Diabetic Retinopathy (DR) and diabetic macular edema with vision-related quality of life, as well as the potential association between the disease’s severity, emotional status of patients and the manifestation of anxiety and psychological features. Results: Patients with fundoscopic findings had significantly lower scores in all VFQ-25 subscales, indicating worse quality of life in comparison to patients without DR. Severity of DR, greater levels of anxiety, daily sitting time, unemployment and lower education level, were all found to be significantly, negatively associated with a worse quality of life. Regarding emotional status, more years of suffering from diabetes, treatment with insulin and the hours being idle per day were associated with an increased burden of anxiety. In addition, the presence of a concomitant disease, findings in fundoscopy, diabetic macular edema and treatment with anti-VEFG injections, as well as the number of doses, were significantly associated with greater anxiety. Multivariate analysis showed that having Severe Non-Proliferative Diabetic Retinopathy or having Proliferative Diabetic Retinopathy and receiving insulin therapy (alone or in combination with another treatment), were significantly associated with higher levels of anxiety. Conclusion: The well-established impact of DR on the patients’ well-being, quality of life and emotional status render DR and CME prevention, stabilization or delaying progression as a necessity in order to protect patients from developing psychiatric symptoms. On the other hand, the speculated bi-directional association between emotional problems and DR progression highlights the importance of acknowledging and dealing with psychological issues with the aim of delaying DR progression.
Subject
Applied Psychology,Clinical Psychology,Developmental and Educational Psychology
Reference43 articles.
1. Diabetic retinopathy and diabetic macular oedema pathways and management: UK Consensus Working Group;Amoaku;Eye,2020 2. Diabetic retinopathy: Global prevalence, major risk factors, screening practices and public health challenges: A review;Ting;Clin. Exp. Ophthalmol.,2016 3. Review Ophthalmologica, Guidelines for the Management of Diabetic Macular Edema by the European Society of Retina Specialists (EURETINA);Bandello;Ophthalmologica,2017 4. Tarr, J.M., Chopra, M., Kohner, E.M., and Chibber, R. (2012). Review Article. Pathophysiology of Diabetic Retinopathy, Institute of Biomedical and Clinical Science, Peninsula College of Medicine and Dentistry, University of Exeter. 5. The Wisconsin Epidemiologic Study of Diabetic Retinopathy;Klein;Ophthalmology,1984
|
|