Psychological and Psychosocial Interventions for Depression and Anxiety in Patients With Age-Related Macular Degeneration: A Systematic Review

Abstract

Purpose: To review the current literature on psychosocial and psychological interventions to prevent and treat depression and anxiety in patients with age-related macular degeneration (AMD). Methods: We conducted a systematic review of literature evaluating psychosocial and psychological interventions for depression and anxiety in AMD patients. Primary searches of PubMed, Cochrane library, EMBASE, Global Health, Web of Science, EBSCO, and Science Direct were conducted to include all papers published until April 21 st. 2018. Results: Of a total of 398 citations retrieved, we selected 12 eligible studies published between 2002 and 2016. We found 9 randomized controlled trials (RCT), and 3 nonrandomised intervention (NRI) studies. RCT studies suggested that interventions using group self-management techniques, and individual behavioural activation plus low vision rehabilitation can be effective to treat and prevent depression in AMD patients, and one study suggested that a stepped-care intervention using cognitive-behavioural techniques can be effective to manage anxiety and depression over time. NRI studies highlighted a positive effect of self-help and emotion-focused interventions to reduce depression. Conclusions: Clinical practice with AMD patients can rely on some tailored cognitivebehavioural therapeutic protocols to improve patients' mental health, but further clinical trials will generate the necessary evidence-based knowledge to improve those therapeutic techniques and offer additional tailored interventions for AMD patients.

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“… 160 Outcomes of these interventions may also depend largely on the age of the individual. While prior studies of psychosocial interventions demonstrate some degree of efficacy in older adults with vision loss, and particularly AMD, 161 meta-analytic findings indicate that improvements are less robust in elderly samples. 160 Related to this finding, risk and protective factors for mental health problems in older adults may be different from those of younger people, 29 and therefore treatment may need to be adapted to fit the individual needs of the consumer.…”

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