Evaluation of Depression and Anxiety in a Diverse Population With Thyroid Eye Disease Using the Nationwide NIH All of Us Database

Author:

Lee Tonya C.1,Radha-Saseendrakumar Bharanidharan12,Delavar Arash12,Ye Gordon Y.12,Ting Michelle A.34,Topilow Nicole J.34,Bass Jeremy5,Korn Bobby S.34,Kikkawa Don O.34,Baxter Sally L.12,Liu Catherine Y.34

Affiliation:

1. Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California, U.S.A.

2. UCSD Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California, U.S.A.

3. Division of Oculofacial Plastic and Reconstructive Surgery, Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, La Jolla, California, U.S.A.

4. Division of Plastic and Reconstructive Surgery, Department of Surgery, University of California San Diego, La Jolla, California, U.S.A.

5. Department of Psychiatry, University of California San Diego, La Jolla, California, U.S.A.

Abstract

Purpose: To evaluate the prevalence of depression and anxiety among individuals with thyroid eye disease (TED) and identify sociodemographic risk factors using the NIH All of Us database. Methods: Three hundred ninety eight cases with TED were compared with 1,592 controls with demographics matching the 2020 US Census. Primary outcomes were diagnosed depression or anxiety; Patient Health Questionnaire-9 (PHQ-9) scores and General Anxiety Disorder-7 (GAD-7) scores were included as secondary outcomes. We performed multivariable logistic regression to generate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between TED and depression and anxiety. Results: Patients with TED were more likely to have depression (OR 2.72, 95% CI 2.08–3.56, p < 0.001) and anxiety (OR 2.82, 95% CI 2.16–3.70, p < 0.001) than controls. In patients with TED, female gender was an independent risk factor for both depression (OR 1.72; 95% CI 1.00–5.07, p = 0.05) and anxiety (OR 2.17, 95% CI 1.25–3.85, p = 0.006). Unemployment (OR 1.72, 95% CI 1.03–2.94, p = 0.04) and lower income (OR 0.88 for income as a continuous variable, 95% CI 0.79–0.99, p = 0.03) were risk factors for anxiety. Risk factors for more severe depression as assessed by PHQ-9 included lower income (OR 0.70, 95% CI 0.57–0.85, p < 0.001), and protective factors included Black race (OR 0.12, 95% CI 0.02–0.45, p = 0.002). Lower income was associated with more severe anxiety as assessed by GAD-7 (OR 0.77, 95% CI 0.64–0.94, p = 0.009). Conclusions: Patients with TED were more likely to develop depression and anxiety compared with controls. This study highlights the psychosocial impact of TED and associated socioeconomic risk factors.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Ophthalmology,General Medicine,Surgery

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