Prediction of vulnerability to mental health symptoms in children with congenital ectopia lentis: development and validation of a prediction model.

Objective: To evaluate mental health among children with congenital ectopia lentis (CEL) and to develop an effective nomogram for predicting risk of mental health symptoms in CEL.

Methods: In total, 48 children with CEL and 50 control subjects aged 7-18 years old were enrolled in this study. Participants were required to complete the Children's Depression Inventory (CDI) and the Screen for Child Anxiety Related Emotional Disorders (SCARED) questionnaire to screen depressive and anxiety symptoms. Three potential predictors were tested and chosen to build a prediction model using logistic regression.

Results: Compared with normal controls, CDI and SCARED scores were higher among children with CEL (P < 0.05). 35.4% of CEL children had varying degrees of depressive or anxiety symptoms. Child's age (odds ratio [OR] = 1.815, 95% confidence interval [CI], 1.084-3.039), duration of disease (OR = 1.557, 95% CI, 1.009-2.403), and systemic abnormalities (OR = 19.894, 95% CI, 1.660-238.463) were identified as predictors of anxiety symptoms. The combination of the above predictors shows good predictive ability, as indicated by area under the curve of 0.924 (95% CI, 0.845-1.000). The calibration curves showed good agreement between the prediction of the nomogram and the actual observations. Additionally, decision curve analysis showed that the nomogram was clinically useful and had better discriminatory power in identifying patients with significant anxiety symptoms.

Conclusions: Children with CEL experience higher level of depressive and anxiety symptoms. Child's age, duration of disease and systemic abnormalities are associated factors and can serve as useful indexes in predicting mental illness among CEL children.