Identifying distinct risk factors for vision-specific distress and depressive symptoms in people with vision impairment

Purpose. To determine the relative importance and associated risk factors of vision-specific distress and depressive symptoms in people with visual impairments. Methods. In this cross-sectional study, 162 adult patients with visual acuity less than 6/12 were interviewed using telephone-administered questionnaires. Vision-specific distress was assessed with the emotional well-being scale of the Impact of Vision Impairment Questionnaire. Depressive symptoms were assessed with the Patient Health Questionnaire-9. Other measures including vision-specific functioning, coping, and social support were also assessed. Multiple regression and commonality analysis were used to determine the relative contribution of factors explaining variance in vision-specific distress and depressive symptoms. Results. Vision-specific distress and depressive symptoms were strongly associated. Vision-specific functioning (βs = 0.47, P < 0.001), avoidant coping (βs = -0.32, P < 0.001), social coping efficacy (βs = -0.17, P = 0.001), and depressive symptoms (βs = 0.18, P = 0.006) were significant determinants of vision-specific distress. Vision-specific functioning accounted for 37.7% of the unique variance in this model. Vision-specific distress was an important risk factor for depression, accounting for 36.6% of the unique variance in depressive symptoms. Conclusions. Vision-specific distress is related to a person's ability to manage the practical and social challenges of vision impairment. Further work is required to distinguish vision-specific distress and depression and to examine what interventions are best to target vision-specific distress. © 2013 The Association for Research in Vision and Ophthalmology, Inc.