Burden of significant anxiety and stress symptoms in persons with visual impairment in a Nigerian hospital: Association with vision-related quality of life

Background: Visual impairment (VI) presents a unique situation for adaptation with diverse socio-cultural and psychological consequences. However, the treatment of patients with visual impairment (PVI) in Nigeria is yet to embrace the biopsychosocial model thereby leaving huge unmet mental health needs. Aims: The aim of the study was to determine the burden of anxiety disorders and stress symptoms in PVI and highlight its relationship with vision-related health status. Subjects and Methods: This was a cross-sectional study involving 400 PVI using standard criteria. Screening for anxiety disorders and stress symptoms was done using the 21-item Depression, Anxiety and Stress Scale (DASS). Diagnosis of anxiety disorders was confirmed using relevant modules of the Mini-International Neuropsychiatric Inventory (MINI). The vision-targeted health status was measured using the 25-Item Visual Function Questionnaire (WHO-NEI-VFQ-25). Multivariate linear regression model was used to determine the potential predictors of general health and vision sub-scales of quality of life. Results: The prevalence (95% confidence interval [CI]) of anxiety disorders and significant stress symptoms were 29.5% (25.1%–34.2%) and 34.5% (29.9%–39.4%), respectively. Vision-related quality of life scores in the domains of general health, general vision, ocular pain and mental health were significantly lower in participants with anxiety disorders when compared with those without (P < 0.05). Conclusion: The findings of this study support the thinking that the presence of significant anxiety and stress symptoms lower the quality of life of the visually impaired. This has implications for clinical practice in the areas of routine screening for psychiatric morbidities and integration of psychosocial care into ophthalmic care.