Screening and analysis of influencing factors for comorbidity of chronic glaucoma with depression and anxiety

Abstract

BACKGROUND

It has been reported that the prevalence of glaucoma among the global population aged 40-80 years is 3.50%. The majority of patients with chronic glaucoma experience psychological stress in the form of depression and anxiety, which may contribute to disease progression via psychoneuroendocrine mechanisms. However, current clinical screening for these comorbidities remains incomplete.

AIM

To analyse the specific prevalence of depression and anxiety in patients with chronic glaucoma and to investigate the potential associated factors.

METHODS

A total of 220 patients with chronic glaucoma who received treatment at our hospital between January 2024 and October 2025 were included in the study. Their levels of depression and anxiety were assessed using the Generalised Anxiety Disorder Scale and the Patient Health Questionnaire Depression Scale questionnaire. According to the screening results, we divided the 220 patients into a comorbid depression and anxiety group (n = 61) and a non-comorbid group (n = 159). Sociodemographic data, ophthalmic clinical characteristics, and medication history were collected. Univariate and multivariate logistic regression analyses were performed to identify independent influencing factors for comorbid depression and anxiety and to construct a joint prediction model.

RESULTS

Among the 220 chronic glaucoma patients, the detection rate of comorbid depression and anxiety was 27.73%. The proportions of female patients, patients aged ≥ 40 years, those living in urban environments, those with an education level below high school, those with a monthly family income ≤ 3000 yuan, those with a disease duration ≥ 10 years, and those with moderate-to-advanced visual field defects were significantly higher in the comorbid group than in the non-comorbid group, while best-corrected visual acuity was lower in the comorbid group. Univariate logistic regression analysis showed that age, education level, monthly family income, disease duration, stage of visual field defect, and degree of visual impairment were associated with comorbid depression and anxiety. Multivariate logistic regression analysis indicated that longer disease duration, more severe visual field defects, and lower monthly family income were independent risk factors for comorbid depression and anxiety in chronic glaucoma patients. The Hosmer-Lemeshow test showed good model calibration.

CONCLUSION

Comorbid depression and anxiety are relatively common in patients with chronic glaucoma. Longer disease duration, more severe visual field defects, and poorer economic status are independent risk factors. Clinical attention should be paid to the psychological screening and comprehensive intervention for such patients.

Keywords: Glaucoma; Comorbid depression and anxiety; Screening; Influencing factors; Predictive model; Visual field defect

Core Tip: This analysis of 220 chronic glaucoma patients identified a 27.73% comorbidity rate of depression and anxiety. Longer disease duration, more severe visual field defects, and lower monthly family income were independent risk factors. It is therefore necessary to carry out psychological assessments and implement multi-dimensional interventions for this patient group.