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Blepharitis and Depression

 
sad-crying-depressionDepression is a much ignored symptom of Blepharitis. Like many people suffering with blepharitis I found it a very depressing experience. It tends to make you very self conscious.  You start avoiding social occasions where you will be up close talking to people you don’t know well and generally being more withdrawn.  In researching this I came across the below study which I have included on this website for two reasons.

Firstly to let you know you are not alone if you are feeling isolated and depressed with the symptoms of blepharitis.  That is how I felt and it was at least a little comfort to know others felt the same.

Secondly, a warning about the potential side-effects of some of the treatments that are offered for blepharitis.

To save you wading through lots of dry statistical information I will give you a summary.

Patients with blepharitis are at elevated risks of anxiety and depression.

The risk is higher in earlier period after the diagnosis of blepharitis, and declines by time, but remains significantly higher for those with blepharitis than those without blepharitis.

The WHO World Health Survey shows that patients with chronic diseases are more likely to have comorbidity of depression.
For patients with blepharitis, in addition to the burden of the disease and vision disturbance, there are other factors that may contribute to the risk of psychologic condition.

The drugs used to treat inflammatory diseases, such as corticosteroids,

have been associated with the risk of mania, depression, and other behavioral changes. There are also evidences that cytokines are able to cross the blood-brain barrier linking with behavioral changes in patients with chronic inflammation. A combination of these factors may place patients with ocular inflammatory diseases at an elevated risk for mood dysfunction.


Copyright:  2013 Chiang et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License,

The Below information is an extract from
Chun-Chi Chiang1,2, Cheng-Li Lin3, Yi-Yu Tsai1,2, Chiao-Ling Peng3, Ya-Tang Liao3, Fung-Chang Sung3,4*
1 Department of Ophthalmology, China Medical University Hospital, Taichung, Taiwan, 2 School of Medicine, China Medical University, Taichung, Taiwan, 3 Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan, 4 Department of Public Health, China Medical University College of Public Health, Taichung, Taiwan

Patients with Blepharitis Are at Elevated Risk of Anxiety and Depression
Chun-Chi Chiang1,2, Cheng-Li Lin3, Yi-Yu Tsai1,2, Chiao-Ling Peng3, Ya-Tang Liao3, Fung-Chang Sung3,4*
1 Department of Ophthalmology, China Medical University Hospital, Taichung, Taiwan, 2 School of Medicine, China Medical University, Taichung, Taiwan, 3 Management
Office for Health Data, China Medical University Hospital, Taichung, Taiwan, 4 Department of Public Health, China Medical University College of Public Health, Taichung, Taiwan

Abstract
Purpose: Population-based cohort study on the risk of anxiety and depression in patients with blepharitis is limited. This study evaluated whether blepharitis patients are at a higher risk of anxiety and depression.
Design: A retrospective cohort study.
Methods: We used the universal insurance claims data from 1997 to 2010 in Taiwan to identify annually patients with newly diagnosed blepharitis (N = 9764) and without the disease (N = 39056). Incidences, rate ratios (IRR) and hazard ratios (HR) of anxiety and depression were measured for both cohorts by baseline demographic characteristics and comorbidities until the end of 2010.
Results: Compared with the non-blepharitis cohort, the blepharitis cohort had higher incidence of anxiety (15.9 vs. 9.5 per
1000 person-years), with an adjusted HR of 1.58 (95% confidence interval (CI) = 1.46–1.70). The incidence of depression was also higher in the blepharitis cohort (7.66 vs. 5.05 per 1000 person-years), with an adjusted HR of 1.42 (95% CI = 1.28–1.58).

The blepharitis cohort to the non-blepharitis cohort IRR decreased from 1.73 in the first quartile to 1.32 in the 4th quartile for
anxiety, and from 1.67 to 1.29 for depression.

Conclusions: Patients with blepharitis are at elevated risks of anxiety and depression. The risk is higher in earlier period after the diagnosis of blepharitis, and declines by time, but remains significantly higher for those with blepharitis than those
without blepharitis.

Citation: Chiang C-C, Lin C-L, Tsai Y-Y, Peng C-L, Liao Y-T, et al. (2013) Patients with Blepharitis Are at Elevated Risk of Anxiety and Depression. PLoS ONE 8(12):
e83335. doi:10.1371/journal.pone.0083335
Editor: Jerson Laks, Federal University of Rio de Janeiro, Brazil
Received April 8, 2013; Accepted November 2, 2013; Published December 30, 2013
Copyright:  2013 Chiang et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: This study was supported in part by the Executive Yuan National Sciences Council (grant numbers NSC 100-2621-M-039-001), China Medical University
Hospital (grant number 1MS1 and DMR-101-075), and Taiwan Department of Health Clinical Trial and Research Center for Excellence (grant number DOH101-TDB-111-004) and Cancer Research Center of Excellence (DOH101-TD-C-111-005). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing Interests: The authors have declared that no competing interests exist.
* E-mail: fcsung@mail.cmu.edu.tw

Introduction
Characterized by inflamed eyelids, blepharitis is a high prevalent ophthalmic complains difficult to cure in eye care
practices[1]. Crust or flakes on eyelashes, stuck eyelids, reddish eyelids, and blurred vision are the common signs and symptoms[2]. The onset of blepharitis can be acute, other than the more generally form of long standing chronic inflammation.Staphylococcal infection, seborrheic, and meibomian gland dysfunction (MGD) are major etiological cause of these conditions[3]. Patients suffer discomfort evaporative dry eye disease are mainly associated with MSG because of ocular surface inflammation[2].The ocular surface condition may further exacerbate due to immune-mediated inflammatory processes[4]. The persistent discomfort eyes, and unattractive appearance, and uneasy feeling may precipitate psychological stress and negative social implications for patients, including depressed and anxious mood[1].

This study conducted a retrospective follow-up observation to estimate the risk of depression and anxiety in PLOS ONE | www.plosone.org 1 December 2013 | Volume 8 | Issue 12 | e83335 patients with blepharitis using a nationwide insurance dataset in Taiwan.

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