Yuan Y, Jian FJ, Wang L, Zhou BQ, Lin WE, Pang L, Wang Y. Psychological states in diabetic retinopathy: Social support correlates and risk factors. World J Psychiatry 2026; 16(4): 112523 [DOI: 10.5498/wjp.v16.i4.112523]
Corresponding Author of This Article
Yan Wang, PhD, Department of Ophthalmology, Guangdong Provincial Second Hospital of Traditional Chinese Medicine, No. 60 Hengfu Road, Guangzhou 510000, Guangdong Province, China. wangyan96000@126.com
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Psychology
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Observational Study
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Apr 19, 2026 (publication date) through Apr 1, 2026
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World Journal of Psychiatry
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2220-3206
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Yuan Y, Jian FJ, Wang L, Zhou BQ, Lin WE, Pang L, Wang Y. Psychological states in diabetic retinopathy: Social support correlates and risk factors. World J Psychiatry 2026; 16(4): 112523 [DOI: 10.5498/wjp.v16.i4.112523]
World J Psychiatry. Apr 19, 2026; 16(4): 112523 Published online Apr 19, 2026. doi: 10.5498/wjp.v16.i4.112523
Psychological states in diabetic retinopathy: Social support correlates and risk factors
Yuan Yuan, Fang-Jie Jian, Lu Wang, Bing-Qian Zhou, Wan-Er Lin, Long Pang, Yan Wang
Yuan Yuan, Lu Wang, Bing-Qian Zhou, Wan-Er Lin, Long Pang, Department of Ophthalmology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510000, Guangdong Province, China
Fang-Jie Jian, The Second Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou 510000, Guangdong Province, China
Yan Wang, Department of Ophthalmology, Guangdong Provincial Second Hospital of Traditional Chinese Medicine, Guangzhou 510000, Guangdong Province, China
Author contributions: Yuan Y designed the research and wrote the first manuscript; Yuan Y, Jian FJ, Wang L, Zhou BQ, Lin WE, Pang L, and Wang Y contributed to conceiving the research and analyzing data; Wang Y conducted the analysis and provided guidance for the research; all authors reviewed and approved the final manuscript.
Supported by the Special Research Project in Guangdong Provincial Hospital of Chinese Medicine, No. YN2023WSSQ06; Research and Innovation Fund of the Second Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine, No. SEZYY2024C01; and National Natural Science Foundation of China, No. 82405485.
Institutional review board statement: This study was approved by the Ethics Committee of the Second Affiliated Hospital of Guangzhou University of Chinese Medicine.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: No additional data are available.
Corresponding author: Yan Wang, PhD, Department of Ophthalmology, Guangdong Provincial Second Hospital of Traditional Chinese Medicine, No. 60 Hengfu Road, Guangzhou 510000, Guangdong Province, China. wangyan96000@126.com
Received: October 10, 2025 Revised: November 25, 2025 Accepted: January 4, 2026 Published online: April 19, 2026 Processing time: 171 Days and 0.7 Hours
Abstract
BACKGROUND
Diabetic retinopathy (DR) is closely and bidirectionally linked to psychological distress, yet research examining anxiety, depression, and social support among such patients remains limited.
AIM
To evaluate associations between psychological status and social support in DR and identify contributing risk factors.
METHODS
We enrolled 125 patients with DR treated at the Second Affiliated Hospital of Guangzhou University of Chinese Medicine (January 2022-January 2025). Anxiety, depression, and social support were assessed using the Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), and Social Support Rating Scale (SSRS). Spearman’s or Pearson’s correlation coefficients were used to analyze correlations between anxiety or depression and social support, and single- and multivariable regressions were used to identify key influencing factors.
RESULTS
Overall, 33.60% of participants experienced anxiety (HAMA: 11.1 ± 5.22) and 24.8% experienced depression (HAMD: 10.83 ± 5.75); the incidences of anxiety or depression and combined anxiety-depression were 49.60% and 8.8%, respectively. Mean SSRS scores were 34.37 ± 7.69, with sub-scores of 20.85 ± 6.59, 6.89 ± 5.92, and 6.63 ± 2.70. HAMA and HAMD scores were inversely correlated with SSRS (r = -0.396/-0.481, P < 0.001), a pattern that persisted in non-proliferative DR. Longer diabetes mellitus (DM) duration (≥ 8 years), visual disturbances, hypertension, and a family history of DM increased the likelihood of psychological distress, whereas social support (SSRS ≥ 35) had a protective effect.
CONCLUSION
Psychological distress affects nearly half of DR patients (49.60%). For those with non-proliferative DR, anxiety and depression show a strong negative association with social support. A prolonged DR course (≥ 8 years), visual impairment, hypertension, DM family history, and SSRS < 35 elevate distress risk.
Core Tip: This study analyzed patients with diabetic retinopathy (DR) to evaluate the correlations between psychological distress and social support and identify influencing factors. Nearly half of the cohort experienced anxiety or depression. In non-proliferative DR, anxiety and depression showed a significant negative correlation with social support, whereas findings in proliferative DR require validation in larger samples. Patients with a long diabetes mellitus duration, visual impairment, hypertension, a family history of diabetes mellitus, and low social support level were at heightened risk for psychological distress.
