Evaluation of the Emotional Status in Patients with Retinitis Pigmentosa Using PHQ-9 and Zung Scores: Is the Depression Common in Retinitis Pigmentosa?

Objective: To assess the depression prevalence and its potential correlation with visual loss in patients with retinitis pigmentosa. Methods: Fifty-five patients with retinitis pigmentosa and 32 ageand sex-matched healthy individuals were recruited in this case-control study. All participants underwent a complete ophthalmological examination, which included measurement Best-corrected visual acuity (BCVA), slit lamp examination and fundoscopy, and completed the Patient Health Questionnaire-9 (PHQ-9) and the Zung Depression Inventory questionnaire. The diagnosis and the evaluation of retinitis pigmentosa were based on spectral domain optical coherence tomography (SD-OCT) and fundus autofluorescence (FAF) examination with dilated pupils. Results: The patients’ group consisted of 44 males and 11 females with mean age of 41.4 ± 7.6 years old, whereas the controls’ group included 19 males and 13 females with mean age of 42.5 ± 10.1 years old. BCVA differed significantly between the two groups, as expected (Mann-Whitney test: p<0.0001). The mean values of PHQ-9 and Zung scores in patients with retinitis pigmentosa classified them as moderately depressive or normal, respectively. The control group was characterized as mildly depressive or normal, according to PHQ-9 and Zung scores, respectively. Both scores were increased among patients (10.0 ± 3.9 and 45.2 ± 2.1, respectively) compared to the control group (6.7 ± 5.4 and 41.1 ± 8.5, respectively) and these increments were statistically significant (MannWhitney test: p=0.005 and p=0.024, respectively). PHQ-9 and Zung scores appeared to be weakly but significantly correlated (Spearman’s coefficient=-0.29, p=0.006). The increased age seemed to be responsible for the depressive symptoms, according to the PHQ-9 score but not with respect to the Zung score. Conclusion: Patients with retinitis pigmentosa exhibited more frequently and intensely depressive symptoms in PHQ-9 scores, compared to the healthy individuals. Moderate depression was significantly correlated visual function decline and increasing age. Ophthalmologists should be aware of the emotional disorders and encourage the patients to receive psychological support.