Diabetic retinopathy is the leading cause of blindness in patients between 25 and 74 years old, according to the study appearing online in the journal General Hospital Psychiatry.
The study, as per the authors, while controling for obesity, smoking, sedentary lifestyle and HbA1c levels, found that increased risk of retinopathy in those patients who are depressed. The authors studied 2,359 patients with diabetes enrolled in the Pathways Epidemiologic Study and assessed their levels of depression using the Patient Health Questionnaire-9 (PHQ-9), a self-reported survey of depression symptoms.
Over the five-year follow-up period, 22.9 percent of the patients who had PHQ-9 scores that ranked as “major depression” developed diabetic retinopathy, compared with 19.7 percent of the patients without depression. With a five-point increase on the PHQ-9 score, patients’ risk of having diabetic retinopathy increased by up to 15 percent.
The authors conclude that changes associated with depression such as increased cortisol levels and the activity of blood-clotting factors may be linked to the development of retinopathy in patients who are depressed. They also add that multiple explanations might account for these findings, with some of them related to biological changes and others to behavioral social issues, such as decreased physical activity and poorer utilization of health care.
The question that arises is whether identifying and treating depression in patients with diabetes will make a difference to development or pregression of retinopathy.
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