High prevalence of sleep and mood disorders in dry eye patients: survey of 1,000 eye clinic visitors

Purpose: We aimed to explore the prevalence of probable sleep and mood disorders in eye clinic visitors. Methods: This was a cross-sectional study. The participants were outpatients at six eye clinics from January through March, 2014. Outpatients were invited to complete a questionnaire containing the Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression Scale (HADS). A final diagnosis was made, and patients were classified into six diagnostic groups. The main outcome measures were the scores of the PSQI and HADS among the diagnostic groups. Results: A total 1,000 outpatients participated, and 730 patients (mean age 59.5 +/- 19.0 years; 487 females) were analyzed after exclusion of children and patients diagnosed with healthy eyes, acute injury, or unilateral pseudophakia. The mean PSQI and HADS scores across all patients were 5.3 +/- 3.1 and 9.2 +/- 6.2, respectively. For the diagnostic groups, the mean PSQI and HADS scores, respectively, were 5.7 +/- 3.3 and 10.2 +/- 6.0 for dry eye (n=247), 5.4 +/- 3.2 and 9.2 +/- 5.7 for bilateral cataracts (n=159), 5.3 +/- 3.3 and 8.0 +/- 5.3 for bilateral pseudophakia (n=99), and, 5.0 +/- 3.1 and 9.8 +/- 6.6 for glaucoma (n=109). Overall, 37.3% of patients were poor sleepers (PSQI >= 6), and 45.5% had possible mood disorders (HADS > 10). Stepwise regression analysis revealed that the PSQI and HADS scores were significantly correlated with both age (P<0.05) and the presence of dry eye (P<0.05). Conclusion: The prevalence of sleep and mood disorders was significantly higher in patients with dry eye. The present results suggest consultation-liaison psychiatry services may be beneficial among eye disease patients.