Purpose

Dry eye (DE) disease and depression are increasing in modern times. We investigated the association between DE and depressive symptoms using the iPhone application, DryEyeRhythm.

Methods

This large-scale crowdsourced observational study was conducted within iPhone users in Japan who downloaded DryEyeRhythm. Participants with a Zung Self-rating Depression Scale (SDS) score ≥ 40 were defined as having depressive symptoms, and those with an Ocular Surface Disease Index (OSDI) score ≥ 13 were defined as having DE symptoms (mild, 13–22; moderate, 23–32; and severe, 33–100). We compared SDS scores between participants with normal eye and mild, moderate, and severe OSDI-based DE symptoms. Logistic regression analyses were used to determine the association between DE severity and depressive symptoms after adjustment for demographic characteristics, medical history, and lifestyle habits.

Results

This study included 4454 participants (mean age, 27.9 ± 12.6 years; female, 66.7%). Participants with SDS scores ≥40 accounted for 58.2%, 70.9%, 79.4%, and 85.0% of normal controls and participants with mild, moderate, and severe DE symptoms, respectively (P trend < 0.001). The adjusted odds ratios (95% confidence interval) for depressive symptoms (SDS score of ≥40) were 1.62 (1.35–1.95) for mild, 2.39 (1.92–2.97) for moderate, and 3.29 (2.70–4.00) for severe DE symptoms.

Conclusion

This large-scale crowdsourced clinical study using DryEyeRhythm suggests that depressive symptoms are more common in individuals with more severe DE symptoms. DryEyeRhythm could play a role in earlier prevention or future prospective interventions for depressive symptoms in individuals with DE symptoms.

中文翻译：

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干眼症与抑郁症状之间的关联：使用DryEyeRhythm iPhone应用程序进行的大规模众包研究。

目的

在现代，干眼病和抑郁症正在增加。我们使用iPhone应用程序DryEyeRhythm调查了DE和抑郁症状之间的关系。

方法

这项大规模的众包观测研究是在下载了DryEyeRhythm的日本iPhone用户中进行的。Zung自评抑郁量表（SDS）得分≥40的参与者被定义为有抑郁症状，而眼表疾病指数（OSDI）分数≥13的参与者被定义为具有DE症状（轻度，13–22；中度） ，23-32；严重的是33-100）。我们比较了正常眼睛和轻度，中度和重度基于OSDI的DE症状的参与者的SDS评分。在对人口统计学特征，病史和生活方式习惯进行调整后，使用逻辑回归分析确定DE严重程度与抑郁症状之间的关联。

结果

这项研究包括4454名参与者（平均年龄27.9±12.6岁；女性66.7％）。SDS得分≥40的参与者分别占正常对照组和轻度，中度和重度DE症状参与者的58.2％，70.9％，79.4％和85.0％（P趋势<0.001）。抑郁症状（SDS≥40）的校正优势比（95％置信区间）为轻度1.62（1.35–1.95），中度2.39（1.92–2.97）和重度DE症状3.29（2.70–4.00） 。

结论

这项使用DryEyeRhythm的大规模众包临床研究表明，抑郁症状在DE症状较严重的个体中更为常见。DryEyeRhythm可能在DE症状患者的抑郁症状的早期预防或未来预期干预中发挥作用。