Evaluation of Anxiety and Depression Using Hospital Anxiety and Depression Scale in Patients With Advanced Diabetic Eye Disease
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Abstract
Introduction: Advanced diabetic eye disease (ADED) is the debilitating sequelae of diabetic retinopathy (DR). It a chronic disease and require life-long treatment. The mental health of patients with chronic disease were often affected. Method: A cross-sectional study was conducted involving ADED patients from Hospital Universiti Sains Malaysia (USM) and Hospital Sultanah Aminah from 1 May 2022 till December 2023. Diabetic patients with no DR were included as control group. Ocular examinations using slit lamp biomicroscopy were performed and HADS was used to assess patient's anxiety and depression. Result: A total of 108 diabetic patients were included in this study (54 ADED and 54 no DR). Percentage of ADED patients with anxiety and depression based on HADS score cut-off point of 8 or more were 64.8% and 61.1% respectively. The mean HADS for anxiety (HADS-A) score was significantly higher in ADED (8.15 SD 4.42) than in no DR (4.15 SD 3.02) (p<0.001). The mean HADS for depression (HADS-D) score was significantly higher in ADED (7.69 SD 3.29) than in no DR (4.28 SD 3.45) (p<0.001). Foot amputation and severe visual impairment were the factors that significantly associated with anxiety and depression. Conclusion: ADED is more susceptible to psychological stress due to visual impairment and chronic medical illness related to complication of DM. A holistic approach to the management of ADED patients should include a thorough evaluation of their mental health status and early referral for mental health care, which may aid in optimising patients’ care and disease outcome.
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