The Emotional State And Psychosocial Factors Of Primary Glaucoma Patients

The Emotional State and Psychosocial factors of Primary Glaucoma PatientsObjective The aim of this study was to assess the impact of psychological distress and personality traits on primary glaucoma patients with self-rated questionnaires in order to seek the possibility of psychological intervention in addition to glaucoma treatment.Method One hundred patients with primary glaucoma participated in the study. Self-rating Anxiety and Depression scale(each consists of 20 items belonging to four clusters of anxiety/depression symptoms),Eysenck Personality Questionnaire(an 88-item personality inventory designed to measure the major dimensions of personality,namely,extraversion/inversion,neuroticism/stability,and psychoticism/socialization),Defense Style Questionnaire(consists of 88 items estimating behavior suggestive of 25 ego mechanisms of defense and four defense styles namely,maladaptive action,image distorting,self-sacrificing,and adaptive styles),and Life event Scale(a 48-item self-report to investigate the significant events including social life,work and others happened during last year) were used.All the procedures were strictly followed in accordance with the steps required in the manual to minimize evaluation error.Explanations of the main purpose,scope,time, frequency,as well as other requirements of questionnaires being used were made to patients by physician,and then the subjects complete the assessments independently. Results of the scales were accumulated for factor score points or sub-scale points and total score points(original points),then converted into various forms of standard score according to the manual.T test and One-way ANOVA were used for inter-group test of significance.Results Gender,marital status,and educational level were evaluated using Logistic regression analysis;age and visual acuity were evaluated using One-way ANOVA; the duration of disease and intraocular pressure were evaluated using T test,and no significant difference was noted(P＞0.05).Results of Self-rating Anxiety/Depression Scale:the scores of anxiety and depression are both higher in glaucoma patients than in normal controls,whereas PACG patients have a significantly higher score for both scales(48.44±9.90,53.64±9.74) than POAG group(42.62±9.00,49.02±11.47) and the control group(37.10±6.08,38.86±6.64)(t test,P＜0.05).Results of Eysenck Personality Questionnaire:the value of P,E,and N of three groups were found to be significantly different(One-wayANOVA,P＜0.05);the value of P(53.60±9.05,47.46±8.24) and the value of N(51.20±22.06,49.18±11.80) of PACG group and POAG group were significantly higher than normal controls(44.20±7.57,42.40±14.88)(t test,p＜0.05).Results of Defense Style Questionnaire:PACG and POAG patients are found to be adopting immature(3.76±0.83,3.91±0.72) and neurotic defense styles (4.91±1.08,4.60±0.56) more than normal controls(3.36±0.63,4.17±0.64)(One-way ANOVA,P＜0.05),while no significance were found in mature defense style.Somatization factor was found to be significantly higher in PACG patients in another comparison between PACG and POAG group.Results of Life Event Scale:PACG and POAG groups have significantly higher amount of negative stimulation(25.98±22.27,22.24±27.76) and total stimulation(39.92±32.27,41.16±43.13) than normal controls(10.06±11.02,24.74±17.45)(One-way ANOVA, P＜0.05).No significances were found between male and female participants in all the questionnaires used(P＞0.05).Conclusion Significant differences were found between primary glaucoma patients and normal controls in psychiatric questionnaires,whereas the level of anxiety and depression was found to be significantly higher in PACG patients than that of POAG patients and normal controls,suggesting that psychological factors are close related to the mechanism of glaucoma.It also suggests that both physical and mental health-being of patients should be taking into account when treating primary glaucoma patients.