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Influence of visual acuity on suicidal ideation, suicide attempts and depression in South Korea
  1. Tyler Hyungtaek Rim1,
  2. Christopher Seungkyu Lee1,
  3. Sung Chul Lee1,
  4. Byunghoon Chung1,
  5. Sung Soo Kim1,2,3,
  6. Epidemiologic Survey Committee of the Korean Ophthalmological Society
  1. 1Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
  2. 2Yonsei healthcare Big Data based Knowledge Integration System Research Center, Yonsei University College of Medicine, Seoul, Korea
  3. 3Institute of Convergence Science, Yonsei University College of Medicine, Seoul, Korea
  1. Correspondence to Professor Sung Soo Kim, Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea; semekim{at}yuhs.ac

Abstract

Background To assess the influence of visual acuity (VA) on suicidal ideation, suicide attempts and depression.

Methods From 2008 to 2012, a total of 28 919 nationally representative participants aged 19 years or older in the Korea National Health and Nutrition Examination Survey underwent additional ophthalmological examinations by the Korean Ophthalmologic Society. Associations between best corrected VA in the better-seeing eye based on decimal fraction and mental health were identified using multivariable logistic regression analysis after adjusting for possible biopsychosocial confounders. Self-reported mental health (suicidal ideation, suicide attempt and depression), Euro Quality of Life-Visual Analog Scale and counselling experience were evaluated by direct interviews. A nomogram for risk of suicidal ideation was generated.

Results By multivariable logistic regression analysis, low VA was significantly associated with suicidal ideation and suicide attempt but not depression. Participants with a VA of no light perception to 0.2 had a nearly twofold and threefold increased risk of suicidal ideation (adjusted OR, 1.85; 95% CI 1.04 to 3.27) and suicidal attempt (adjusted OR, 3.44; 95% CI 0.92 to 12.79), compared with participants with a VA of 1.0. Sociodemographic disparities, including age and socioeconomic status, existed for suicidal ideation, suicidal attempt and depression. Euro Quality of Life-Visual Analog Scale significantly decreased as VA decreased and was lower in participants who attempted suicide.

Conclusions Low VA was associated with the occurrence of suicidal ideation or a suicide attempt. Ophthalmologists should embrace their responsibility to help reduce suicidality and prevent suicides in patients with low VA by encouraging them to seek psychiatric care.

  • Epidemiology
  • Vision

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