Trusted Resources: Evidence & Education
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Evaluation of Depression and Anxiety in a Diverse Population With Thyroid Eye Disease Using the Nationwide NIH All of Us Database
source: Ophthalmic Plastic and Reconstructive Surgery
year: 2023
authors: Lee, Tonya C; Radha-Saseendrakumar, Bharanidharan; Delavar, Arash; Ye, Gordon Y; Ting, Michelle A; Topilow, Nicole J; Bass, Jeremy; Korn, Bobby S; Kikkawa, Don O; Baxter, Sally L; Liu, Catherine Y
summary/abstract:Purpose:
To evaluate the prevalence of depression and anxiety among individuals with thyroid eye disease (TED) and identify sociodemographic risk factors using the NIH All of Us database.
Methods:
Three hundred ninety eight cases with TED were compared with 1,592 controls with demographics matching the 2020 US Census. Primary outcomes were diagnosed depression or anxiety; Patient Health Questionnaire-9 (PHQ-9) scores and General Anxiety Disorder-7 (GAD-7) scores were included as secondary outcomes. We performed multivariable logistic regression to generate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between TED and depression and anxiety.
Results:
Patients with TED were more likely to have depression (OR 2.72, 95% CI 2.08–3.56, p < 0.001) and anxiety (OR 2.82, 95% CI 2.16–3.70, p < 0.001) than controls. In patients with TED, female gender was an independent risk factor for both depression (OR 1.72; 95% CI 1.00–5.07, p = 0.05) and anxiety (OR 2.17, 95% CI 1.25–3.85, p = 0.006). Unemployment (OR 1.72, 95% CI 1.03–2.94, p = 0.04) and lower income (OR 0.88 for income as a continuous variable, 95% CI 0.79–0.99, p = 0.03) were risk factors for anxiety. Risk factors for more severe depression as assessed by PHQ-9 included lower income (OR 0.70, 95% CI 0.57–0.85, p < 0.001), and protective factors included Black race (OR 0.12, 95% CI 0.02–0.45, p = 0.002). Lower income was associated with more severe anxiety as assessed by GAD-7 (OR 0.77, 95% CI 0.64–0.94, p = 0.009).
Conclusions:
Patients with TED were more likely to develop depression and anxiety compared with controls. This study highlights the psychosocial impact of TED and associated socioeconomic risk factors.
organization: University of California San Diego, USADOI: 10.1097/IOP.0000000000002318
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