Increased Levels of Stress Associated with Sensitivity to DED Symptoms

Emotional stress can increase the sensitivity and intensity of dry eye disease symptoms, this study found. Photo: Scott G. Hauswirth, OD. Click image to enlarge. The relationship between ocular diseases and mental problems is not something new. Lifestyle changes are imminent with any kind of condition, and the shift can lead to negative psychological implications. Patients’ mental state transforms as a result of symptoms brought on by unruly health issues, such as dry eye disease (DED). However, disorders may be present prior to a patient’s diagnosis for DED.Levels of anxiety were observed in relation to symptoms of DED in a recent study. Investigators from Croatia conducted a survey that would further their understanding of how to manage patients in order to mitigate potential DED. Consisting of questions from the Ocular Surface Disease Index (OSDI), Anxiety Sensitivity Index (ASI) and Depression Anxiety Stress Scales (DASS21), the team of researchers was able to collect results from a total of 766 adults with DED between the ages of 18 and 88 years old.In addition, broader questions were asked about depression, anxiety and stress. Patients were asked to grade their answers on a scale from 0 (did not apply to me at all) to 3 (applied to me very much or most of the time). Seven questions were offered for each psychological distress, and the grades were added up for a sum total.“This study is among the first studies on a large and healthy Croatian sample exploring the symptoms of DED and its relations with psychological variables,” wrote the authors in the paper published in Vision. Mean scores for each questionnaire and broad emotional questions were reported. OSDI scored 19.5, ASI scored 12.43, DASS21 scored 11.28, depression scored 3.47, anxiety scored 2.64 and stress scored 5.18.The survey revealed that there was a significant, but weak, correlation between OSDI, ASI and other distresses—depression, anxiety and stress. After mediation analysis, DASS21 scores were found to significantly mediate the relationship between ASI and OSDI. The results of this study confirmed the researchers’ hypotheses that worse emotional states lead to more severe DED symptoms and that patients who are more sensitive to psychological distress are more sensitive to DED symptoms.“Anxiety sensitivity also has a direct effect on the perception of dry eye disease symptom severity; thus, the partial complementary mediation model was discovered, which is a valuable addition to our results,” the authors wrote. “These results imply that people who are more sensitive to anxiety symptoms are also sensitive to ocular symptoms and inclined to be on alert for those symptoms, among other body sensations.” They also note that, due to mental distress, DED symptoms can become significantly more intense and the sensitivity towards these outcomes increases.“Due to the lack of definitive explanations of associations of psychological and ocular symptoms, this and similar research efforts make an appeal in favor of a much-needed interdisciplinary approach and the collaboration of eye and mental care experts,” concluded the authors.  Click here for the journal source.  Toth M, Jokić-Begić N, Krašić S. The relationship between anxiety sensitivity, emotional states and dry eye disease symptom severity: a cross-sectional study. Vision 2025;9(2):36.