Depression screening among older adults attending low‐vision rehabilitation and eye‐care services: Characteristics of those who screen positive and client acceptability of screening

Holloway, Edith; Sturrock, Bonnie A.; Lamoureux, Ecosse L.; Keeffe, Jill; Rees, Gwyneth

doi:10.1111/ajag.12159

Cited by 38 publications

(54 citation statements)

References 29 publications

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“…36,37 Severity of vision impairment was not associated with worse vision-related emotional well-being; this finding is contrary to previous studies showing that individuals with vision impairment had increasing levels of depression and/or emotional distress. 38,39 Yet our finding is consistent with other research demonstrating a nonsignificant association between severity of vision impairment and poorer visionrelated emotional well-being. 40,41 Moderate (not severe) vision impairment was associated with decline in visionrelated well-being.…”

Section: Discussionsupporting

confidence: 92%

The Influence of Coping on Vision-Related Quality of Life in Patients With Low Vision: A Prospective Longitudinal Study

Sturrock

Xie

Holloway

et al. 2015

Invest. Ophthalmol. Vis. Sci.

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Section: Discussionsupporting

confidence: 92%

The Influence of Coping on Vision-Related Quality of Life in Patients With Low Vision: A Prospective Longitudinal Study

Sturrock

Xie

Holloway

et al. 2015

Invest. Ophthalmol. Vis. Sci.

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“…Screening questionnaires may be used to identify patients that are less resilient in overcoming subthreshold depression and anxiety. A brief version of the Patient Health Questionnaire (PHQ), which can be used by non-mental health staff to screen for depression and anxiety, may be suitable for this purpose [ 47 , 48 ]. When patients experience depression and/or anxiety based on this short screener, extensive questionnaires can be used to determine whether watchful waiting is appropriate, in which history of depressive and anxiety disorders should be taken into account.…”

Section: Discussionmentioning

confidence: 99%

Watchful waiting for subthreshold depression and anxiety in visually impaired older adults

Bruin

Rens

et al. 2015

Qual Life Res

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PurposeImmediate treatment of depression and anxiety may not always be necessary in resilient patients. This study aimed to determine remission rates of subthreshold depression and anxiety, incidence rates of major depressive and anxiety disorders, and predictors of these remission and incidence rates in visually impaired older adults after a three-month ‘watchful waiting’ period.MethodsA pretest–posttest study in 265 visually impaired older adults (mean age 74 years), from outpatient low-vision rehabilitation services, with subthreshold depression and/or anxiety was performed as part of a randomised controlled trial on the cost-effectiveness of a stepped-care intervention. An ordinal logistic regression analysis was conducted. Main outcome measures were: (1) subthreshold depression and anxiety measured with the Centre for Epidemiologic Studies Depression Scale (CES-D) and the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A), and (2) depressive and anxiety disorders measured with the Mini International Neuropsychiatric Interview.ResultsAfter a three-month watchful waiting period, depression and anxiety decreased significantly by 3.8 (CES-D) and 1.4 points (HADS-A) (p < 0.001). Of all participants, 34 % recovered from subthreshold depression and/or anxiety and 18 % developed a depressive and/or anxiety disorder. Female gender [odds ratio (OR) 0.49, 95 % confidence interval (CI) 0.28–0.86], more problems with adjustment to vision loss at baseline (OR 1.02, 95 % CI 1.00–1.03), more symptoms of depression and anxiety at baseline (OR 1.06, 95 % CI 1.02–1.10), and a history of major depressive, dysthymic, and/or panic disorder (OR 2.28, 95 % CI 1.28–4.07) were associated with lower odds of remitting from subthreshold depression and/or anxiety and higher odds of developing a disorder after watchful waiting.ConclusionsWatchful waiting can be an appropriate step in managing depression and anxiety in visually impaired older adults. However, female gender, problems with adjustment to vision loss, higher depression and anxiety symptoms, and a history of a depressive or anxiety disorder confer a disadvantage. Screening tools may be used to identify patients with these characteristics, who may benefit more from higher intensity treatment or a shorter period of watchful waiting.

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“…Most patients, however, do not feel embarrassed or uncomfortable when discussing depression. 67 Such conversations can be initiated by asking patients what their vision loss is preventing them from doing, how their independence is hindered by AMD, what they fear most about the loss of vision, and whether they are able to participate in enjoyable activities such as hobbies and social interaction. This line of questioning can be followed by the administration of a brief, standardized depression screen.…”

Section: Recommendations For Eye Care Professionalsmentioning

confidence: 99%

Anxiety and depression in patients with advanced macular degeneration: current perspectives

Cimarolli¹,

Casten²,

Rovner³

et al. 2015

OPTH

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Age-related macular degeneration (AMD) – despite advances in prevention and medical treatment options – remains prevalent among older adults, often resulting in functional losses that negatively affect the mental health of older adults. In particular, the prevalence of both anxiety and depression in patients with AMD is high. Along with medical treatment options, low vision rehabilitation and AMD-specific behavioral and self-management programs have been developed and have demonstrated effectiveness in improving the mental health of AMD patients. This article reviews the prevalence of anxiety and depression in patients with advanced AMD, discusses potential mechanisms accounting for the development of depression and anxiety in AMD patients, presents the state-of the-art of available interventions for addressing anxiety and depression in AMD patients, and delineates recommendations for eye care professionals regarding how to screen for these two prevalent mental health problems and how to facilitate appropriate treatment for patients with AMD.

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Depression screening among older adults attending low‐vision rehabilitation and eye‐care services: Characteristics of those who screen positive and client acceptability of screening

Abstract: The PHQ-2 appears to be an acceptable method for depression screening in eye-care settings among older adults. Targeted interventions that incorporate home-based or telephone delivered therapy sessions may improve outcomes for depression in this group.

Cited by 38 publications

References 29 publications

The Influence of Coping on Vision-Related Quality of Life in Patients With Low Vision: A Prospective Longitudinal Study

The Influence of Coping on Vision-Related Quality of Life in Patients With Low Vision: A Prospective Longitudinal Study

Watchful waiting for subthreshold depression and anxiety in visually impaired older adults

Anxiety and depression in patients with advanced macular degeneration: current perspectives

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