Psychic Suffering In Patients With Keratoconus In Southern Brazil

To assess the prevalence of depressive symptoms in patients with keratoconus treated at Hospital de Clínicas de Porto Alegre (HCPA) using the PHQ-9 questionnaire. This study aims to understand the psychological impact of the disease and highlight the importance of early screening. This is the first study to screen for depression in patients with keratoconus in southern Brazil.

Prospective cross-sectional and single-center study, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.

106 patients of various ages, ethnicities, and sexes were recruited from the Contact Lens and Corneal Transplantation Departments of Hospital de Clínicas de Porto Alegre. Only patients with a confirmed diagnosis of keratoconus, as determined by Scheimpflug tomography, were included. The Informed Consent Form and the PHQ-9 questionnaire were applied. Interviews were conducted between March 2023 and January 2024. The study followed the guidelines of the National Research Ethics Commission and was approved by the HCPA Research Ethics Committee (registration 2023-0134). Data was analyzed as percentages when categorical and as means with standart deviation when quantitative and normally distributed.  

A total of 106 patients were evaluated, of whom 58 were male. Ethnicity, based on self-declaration, consisted of 77 White, 28 Black or Brown, and one Asian individuals. The mean age was 32 years (13 - 72 years). In the administered questionnaire, 70% of participants exhibited symptoms ranging from mild to severe depression. Only eight patients scored 0, while the highest score was 12. Additionally, 20% of patients classified themselves as having moderately severe to severe symptoms. The prevalence of depression was 8.99% (95% CI: 7.78–10.20%).

This study reveals the high prevalence of depressive symptoms in patients with keratoconus, particularly in more advanced stages of the disease. The use of the PHQ-9 questionnaire seems effective in early screening of depressive symptoms, highlighting the need for integrated therapeutic approaches, including psychological support, to improve the overall well-being of keratoconus patients.