Background: The experience of intravitreal treatment (IVT) is very heterogeneous among patients. This study investigated how the perceptions of disease and treatment differ for individuals with mental illnesses compared to individuals without mental comorbidities.
Methods: Surveys on the experience of the illness and treatment were conducted at two eye clinics as part of the Hamburg registry for intravitreal injections. Mental comorbidities were assessed through self-reported mental diseases, a generalized anxiety disorder scale value ≥ 3 and moderate to severe anxiety/depression. For assessment of the experience of the disease the impairment of quality of life due to the eye condition was graded on a 6-point scale. Patients rated the treatment experience using scales (0-10) for the intensity of anxiety, tension and pain during the last injection. Group differences were analyzed based on the mean visual acuity using linear regression with age and gender as covariates.
Results: Mental illnesses were present in 14.5% of patients. Of the patients with mental illnesses 27.1% reported a very severe impairment of quality of life (vs. 11.2% in the mentally healthy group), even though the mean visual acuity was comparable in both groups. Mentally ill patients reported higher mean levels of anxiety (+1.5 points, confidence interval, CI 0.76-2.16, p < 0.001) and physical tension (+1.2 points, CI 0.5-1.9, p < 0.001). The pain intensity was slightly but not significantly higher (+0.61 points, p = 0.058).
Discussion: Patients with mental comorbidity experience the illness and IVT more negatively than mentally healthy patients. It therefore makes sense to take the specific concerns of psychologically burdened patients into account when performing IVT.
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