Abstract
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.
Highlights
Glaucoma is one of the most common chronic eye diseases where blindness is a potential outcome
It is 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
In a study by Mabuchi et al comparing patients with primary open angle-glaucoma (POAG) with sex- and age-matched reference subjects, using the Hospital Anxiety and Depression Scale (HADS), it was shown that the prevalence of anxiety or depression was higher in POAG patients than in the reference subjects, which supports the view that glaucoma is related to anxiety and depression and detrimentally affects the quality of life of glaucoma patients.[3,5]
Summary
Glaucoma is one of the most common chronic eye diseases where blindness is a potential outcome. Chronic nature and potential to result in blindness, it can often impose a psychological burden on patients.[1,2] Anxiety and depression are two common forms of psychological disturbance, and previous studies have shown that patients with glaucoma have a greater likelihood of having these conditions.[3,4] In a study by Mabuchi et al comparing patients with primary open angle-glaucoma (POAG) with sex- and age-matched reference subjects, using the Hospital Anxiety and Depression Scale (HADS), it was shown that the prevalence of anxiety or depression was higher in POAG patients than in the reference subjects, which supports the view that glaucoma is related to anxiety and depression and detrimentally affects the quality of life of glaucoma patients.[3,5] Anxiety is characterized by excessive, uncontrollable, and often irrational worry, that is, apprehensive expectation about events or activities. Depression is a state of low mood and aversion to activity that can affect thoughts, behavior, feelings, and sense of well-being, as defined by the Diagnostic and Statistical Manual of Mental Disorders V.6
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