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      Is perceived social support more important than visual acuity for clinical depression and anxiety in patients with age-related macular degeneration and diabetic retinopathy?

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          Abstract

          Objective:

          To investigate whether visual acuity has the same importance as a factor of depression and anxiety comparing with other psychological variables, particularly perceived social support, in patients diagnosed with age-related eye diseases, with and without low vision.

          Design:

          Observational cross-sectional study.

          Setting:

          Patients attending outpatient appointments at the department of ophthalmology of a general hospital in Portugal.

          Subjects:

          Patients with age-related macular degeneration and patients with diabetic retinopathy attending routine hospital appointments were recruited for this study.

          Measures:

          Anxiety and depression were measured using the hospital anxiety and depression scale and perceived social support using the multidimensional scale of perceived social support. Visual acuity was measured with ETDRS charts.

          Results:

          Of the 71 patients, 53 (75%) were diagnosed with diabetic retinopathy, 37 (52%) were female and age (mean ± SD) was 69 ± 12 years. Acuity in the better seeing eye was 0.41 ± 0.33 logMAR. The mean anxiety score was 4.38 ± 3.82 and depression 4.41 ± 3.39. Clinically significant levels of anxiety were found in 21% ( n = 15) of the participants and depression in 18%( n = 13). The total social support score was 5.29 ± 0.61. Significant multivariate regression models were found for anxiety ( R 2 = 0.21, P = 0.016) and for depression ( R 2 = 0.32, P < 0.0001). Social support was independently associated with levels of anxiety and with levels of depression. Gender was independently associated with levels of anxiety.

          Conclusion:

          This study suggests that patients’ perceived social support might be more important than visual acuity as a factor of clinical depression and anxiety in a sample of age-related eye disease patients.

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          Most cited references34

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          Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis.

          Numerous population-based studies of age-related macular degeneration have been reported around the world, with the results of some studies suggesting racial or ethnic differences in disease prevalence. Integrating these resources to provide summarised data to establish worldwide prevalence and to project the number of people with age-related macular degeneration from 2020 to 2040 would be a useful guide for global strategies. We did a systematic literature review to identify all population-based studies of age-related macular degeneration published before May, 2013. Only studies using retinal photographs and standardised grading classifications (the Wisconsin age-related maculopathy grading system, the international classification for age-related macular degeneration, or the Rotterdam staging system) were included. Hierarchical Bayesian approaches were used to estimate the pooled prevalence, the 95% credible intervals (CrI), and to examine the difference in prevalence by ethnicity (European, African, Hispanic, Asian) and region (Africa, Asia, Europe, Latin America and the Caribbean, North America, and Oceania). UN World Population Prospects were used to project the number of people affected in 2014 and 2040. Bayes factor was calculated as a measure of statistical evidence, with a score above three indicating substantial evidence. Analysis of 129,664 individuals (aged 30-97 years), with 12,727 cases from 39 studies, showed the pooled prevalence (mapped to an age range of 45-85 years) of early, late, and any age-related macular degeneration to be 8.01% (95% CrI 3.98-15.49), 0.37% (0.18-0.77), and 8.69% (4.26-17.40), respectively. We found a higher prevalence of early and any age-related macular degeneration in Europeans than in Asians (early: 11.2% vs 6.8%, Bayes factor 3.9; any: 12.3% vs 7.4%, Bayes factor 4.3), and early, late, and any age-related macular degeneration to be more prevalent in Europeans than in Africans (early: 11.2% vs 7.1%, Bayes factor 12.2; late: 0.5% vs 0.3%, 3.7; any: 12.3% vs 7.5%, 31.3). There was no difference in prevalence between Asians and Africans (all Bayes factors <1). Europeans had a higher prevalence of geographic atrophy subtype (1.11%, 95% CrI 0.53-2.08) than Africans (0.14%, 0.04-0.45), Asians (0.21%, 0.04-0.87), and Hispanics (0.16%, 0.05-0.46). Between geographical regions, cases of early and any age-related macular degeneration were less prevalent in Asia than in Europe and North America (early: 6.3% vs 14.3% and 12.8% [Bayes factor 2.3 and 7.6]; any: 6.9% vs 18.3% and 14.3% [3.0 and 3.8]). No significant gender effect was noted in prevalence (Bayes factor <1.0). The projected number of people with age-related macular degeneration in 2020 is 196 million (95% CrI 140-261), increasing to 288 million in 2040 (205-399). These estimates indicate the substantial global burden of age-related macular degeneration. Summarised data provide information for understanding the effect of the condition and provide data towards designing eye-care strategies and health services around the world. National Medical Research Council, Singapore. Copyright © 2014 Wong et al. Open Access article distributed under the terms of CC BY-NC-ND. Published by .. All rights reserved.
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            Part I: frequency of depression after stroke: an updated systematic review and meta-analysis of observational studies.

            Approximately 15 million people who suffer a stroke globally each year are at risk of developing depression.
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              • Article: not found

              Social support and resilience to stress: from neurobiology to clinical practice.

              Numerous studies indicate social support is essential for maintaining physical and psychological health. The harmful consequences of poor social support and the protective effects of good social support in mental illness have been well documented. Social support may moderate genetic and environmental vulnerabilities and confer resilience to stress, possibly via its effects on the hypothalamic-pituitary-adrenocortical (HPA) system, the noradrenergic system, and central oxytocin pathways. There is a substantial need for additional research and development of specific interventions aiming to increase social support for psychiatrically ill and at-risk populations.
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                Author and article information

                Journal
                Clin Rehabil
                Clin Rehabil
                CRE
                spcre
                Clinical Rehabilitation
                SAGE Publications (Sage UK: London, England )
                0269-2155
                1477-0873
                3 March 2021
                September 2021
                : 35
                : 9
                : 1341-1347
                Affiliations
                [1 ]Low Vision and Visual Rehabilitation Lab, Department and Center of Physics – Optometry and Vision Science, University of Minho, Braga, Portugal
                [2 ]Centre for Research in Neuropsychology and Cognitive and Behavioural Intervention (CINEICC) – University of Coimbra, Portugal
                [3 ]School of Health and Social Care, University of Essex, Colchester, UK
                [4 ]Hospital Santa Maria Maior E.P.E, Barcelos, Braga, Portugal
                [5 ]Department of Medicine and Optometry, Linnaeus University, Kalmar, Sweden
                Author notes
                [*]António Filipe Macedo, Department of Medicine and Optometry, Linnaeus University, Norra Kajplan 6, Hus Vita, Kalmar 39182, Sweden. Email: antonio.macedo@ 123456lnu.se
                [*]Hugo Senra, Centre for Research in Neuropsychology and Cognitive and Behavioural Intervention (CINEICC) – University of Coimbra, 3000-115, Coimbra, Portugal; School of Health and Social Care, University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, UK.
                Author information
                https://orcid.org/0000-0001-8054-6473
                https://orcid.org/0000-0003-3436-2010
                Article
                10.1177_0269215521997991
                10.1177/0269215521997991
                8361471
                33657906
                45597383-3e30-4fd5-ba5f-2404dc24127b
                © The Author(s) 2021

                This article is distributed under the terms of the Creative Commons Attribution 4.0 License ( https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 5 February 2021
                : 6 February 2021
                Funding
                Funded by: Essilor Portugal Lda, ;
                Funded by: fundação para a ciência e a tecnologia, FundRef https://doi.org/10.13039/501100001871;
                Categories
                Original Articles
                Custom metadata
                ts1

                Medicine
                depression,anxiety,social support,age-related eye disease
                Medicine
                depression, anxiety, social support, age-related eye disease

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