WESTPORT, CT (Reuters Health) Nov 22 – Nearly one third of adults with advanced macular degeneration (AMD) meet diagnostic criteria for having depressive disorder, according to a recent report.
Dr. Stuart I. Brown and colleagues, from the University of California at San Diego, assessed the prevalence of depressive disorder among 151 adults, 60 years of age and older, with AMD. All subjects had visual acuity scores of 20/60 or worse in their better eye.
Based on Structured Clinical Interview for DSM-IV criteria (SCID-IV), 32.5% of subjects had depressive disorder. The prevalence is nearly twice that found in general populations of older community-dwelling adults.
Regardless of whether depression was present, visual acuity correlated directly with the level of vision-specific disability.
Ophthalmologists and primary care physicians should consider using SCID-IV criteria when taking histories of elderly patients, the authors note in the October issue of Ophthalmology. If depressive disorder is uncovered in an AMD patient, referral for treatment should be considered. In addition, treatment strategies are needed that teach patients how to cope with vision loss.
In a related editorial, Dr. Barbara S. Hawkins, from Johns Hopkins University in Baltimore, comments that the current findings remind "us we must take a broad view of the healthcare needs of AMD patients and ensure that they are referred to low vision specialists, ideally before they have significant vision loss, and to psychiatrists for help with reducing the effects of AMD and comorbidities on performance of daily activities."
Ophthalmology 2001;108:1893-1901.
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