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Association between vision impairment and depression: a 9-year, longitudinal, nationwide, population-based cohort study in South Korea
  1. Hyo Jin Seong1,2,
  2. Jiwon Kim1,
  3. Tae Mi Yook3,
  4. Deokjong Lee4,
  5. Eun Jee Chung1
  1. 1Department of Ophthalmology, National Health Insurance Service Ilsan Hospital, Goyang, South Korea
  2. 2Department of Ophthalmology, Yonsei University College of Medicine, Seodaemun-gu, South Korea
  3. 3Department of Research and Analysis, National Health Insurance Service Ilsan Hospital, Goyang, South Korea
  4. 4Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
  1. Correspondence to Dr Eun Jee Chung, Department of Ophthalmology, National Health Insurance Service Ilsan Hospital, Goyang, Gyeonggi-do, South Korea; eunjee95{at}hanmail.net

Abstract

Background/Aims Vision impairment (VI) increases the risk of various comorbidities, including depression. However, the relationship between depression and VI is unclear, and existing findings are inconsistent. We therefore investigated the risk of depression in adults before and after their registration as visually impaired.

Methods In this longitudinal, nationwide, retrospective cohort study, 131 434 patients (aged ≥18 years) with newly registered VI during 2005–2013 were evaluated using the Korean National Health Insurance Service database. Using 1:1 propensity score matching, randomly selected patients (control group) were compared with patients with VI (patient group) according to age, sex, residential area and household income. Each patient was tracked from 3 years before and 5 years after registration. The risk of depression before and after VI registration was evaluated using a conditional logistic regression model.

Results The risk of depression gradually increased from 3 years before registration (OR, 1.186; 95% CI 1.089 to 1.290), then peaked at the time of registration (OR, 1.925; 95% CI 1.788 to 2.073), and then gradually decreased until 5 years after registration (OR, 1.128; 95% CI 1.046 to 1.216). Male patients, those with severe VI and those aged 18–29 years had a higher risk of depression.

Conclusions Patients with VI had an increased risk of depression from 3 years before to 5 years after registration. Significant risk factors included severity, male sex and younger age. Thus, public mental health services are necessary to provide appropriate support and interventions to people before and after registration as visually impaired.

  • Vision
  • Public health

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.This study used data from the NHIS-NCS 2002–2018, which were released by the Korean National Health Insurance System (NHIS-2020-1-326). The authors alone are responsible for the content and writing of this article.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.This study used data from the NHIS-NCS 2002–2018, which were released by the Korean National Health Insurance System (NHIS-2020-1-326). The authors alone are responsible for the content and writing of this article.

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Footnotes

  • HJS and JK contributed equally.

  • Contributors HJS and JK participated in the design of the study, analysed the results and drafted the manuscript. TMY participated in the design of the study and analysed the results. DL analysed the results and drafted the manuscript. EJC participated in the design of the study, analysed the results and wrote the final manuscript. EJC is responsible for the overall content as the guarantor. EJC accepts full responsibility for the finished work and/or conduct of the study, had access to the data, and controlled the decision to publish. All authors reviewed the manuscript and approved the final version.

  • Funding This work was supported by a National Health Insurance Ilsan Hospital grant (NHIS-2020-20-007).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.