A Population-Based Cohort Study of the Association between Visual Loss and Risk of Suicide and Mental Illness in Taiwan
The psychosocial and health consequences of ocular conditions that cause visual impairment (VI) are extensive and include impaired daily activities, social isolation, cognitive impairment, impaired functional status and functional decline, increased reliance on others, increased risk of motor vehicl...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-05-01
|
| Series: | Healthcare |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2227-9032/11/10/1462 |
| _version_ | 1797599981654245376 |
|---|---|
| author | Chieh Sung Chi-Hsiang Chung Fu-Huang Lin Wu-Chien Chien Chien-An Sun Chang-Huei Tsao Chih-Erh Weng Daphne Yih Ng |
| author_facet | Chieh Sung Chi-Hsiang Chung Fu-Huang Lin Wu-Chien Chien Chien-An Sun Chang-Huei Tsao Chih-Erh Weng Daphne Yih Ng |
| author_sort | Chieh Sung |
| collection | DOAJ |
| description | The psychosocial and health consequences of ocular conditions that cause visual impairment (VI) are extensive and include impaired daily activities, social isolation, cognitive impairment, impaired functional status and functional decline, increased reliance on others, increased risk of motor vehicle accidents, falls and fractures, poor self-rated health, and depression. We aimed to determine whether VI increases the likelihood of a poor prognosis, including mental illness, suicide, and mortality over time. In this large, location, population-based, nested, cohort study, we used data from 2000 to 2015 in the Taiwan National Health Insurance Research Database (NHIRD), which includes diagnoses of all the patients with VI. Baseline features, comorbidities, and prognostic variables were evaluated using a 1:4-matched cohort analysis. Furthermore, comparisons were performed using Cox regression and Bonferroni-correction (for multiple comparisons) to study the association between VI and poor prognosis (mental illness, suicide). The study outcome was the cumulative incidence of poor prognosis among the visually impaired and controls. A two-tailed Bonferroni-corrected <i>p</i> < 0.001 was considered statistically significant. Among the 1,949,101 patients enlisted in the NHIRD, 271 had been diagnosed with VI. Risk factors for poor prognosis and the crude hazard ratio was 3.004 (95% confidence interval 2.135–4.121, <i>p</i> < 0.001). Participants with VI had an increased risk of poor prognosis according to the sensitivity analysis, with a poor prognosis within the first year and first five years. VI was associated with suicide and mental health risks. This study revealed that patients with VI have a nearly 3-fold higher risk of psychiatric disorders, including anxiety, depression, bipolar, and sleep disorders, than the general population. Early detection through comprehensive examinations based on increased awareness in the clinical context may help maintain visual function and avoid additional complications. |
| first_indexed | 2024-03-11T03:42:01Z |
| format | Article |
| id | doaj.art-e5e2dfb8a37543d0b5b7c87a31a409db |
| institution | Directory Open Access Journal |
| issn | 2227-9032 |
| language | English |
| last_indexed | 2024-03-11T03:42:01Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Healthcare |
| spelling | doaj.art-e5e2dfb8a37543d0b5b7c87a31a409db2023-11-18T01:32:44ZengMDPI AGHealthcare2227-90322023-05-011110146210.3390/healthcare11101462A Population-Based Cohort Study of the Association between Visual Loss and Risk of Suicide and Mental Illness in TaiwanChieh Sung0Chi-Hsiang Chung1Fu-Huang Lin2Wu-Chien Chien3Chien-An Sun4Chang-Huei Tsao5Chih-Erh Weng6Daphne Yih Ng7Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, TaiwanSchool of Public Health, National Defense Medical Center, Taipei 11490, TaiwanSchool of Public Health, National Defense Medical Center, Taipei 11490, TaiwanSchool of Public Health, National Defense Medical Center, Taipei 11490, TaiwanDepartment of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City 24205, TaiwanDepartment of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, TaiwanDepartment of Nursing, Keelung Chang Gung Memorial Hospital, Keelung 20401, TaiwanDepartment of Family Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, TaiwanThe psychosocial and health consequences of ocular conditions that cause visual impairment (VI) are extensive and include impaired daily activities, social isolation, cognitive impairment, impaired functional status and functional decline, increased reliance on others, increased risk of motor vehicle accidents, falls and fractures, poor self-rated health, and depression. We aimed to determine whether VI increases the likelihood of a poor prognosis, including mental illness, suicide, and mortality over time. In this large, location, population-based, nested, cohort study, we used data from 2000 to 2015 in the Taiwan National Health Insurance Research Database (NHIRD), which includes diagnoses of all the patients with VI. Baseline features, comorbidities, and prognostic variables were evaluated using a 1:4-matched cohort analysis. Furthermore, comparisons were performed using Cox regression and Bonferroni-correction (for multiple comparisons) to study the association between VI and poor prognosis (mental illness, suicide). The study outcome was the cumulative incidence of poor prognosis among the visually impaired and controls. A two-tailed Bonferroni-corrected <i>p</i> < 0.001 was considered statistically significant. Among the 1,949,101 patients enlisted in the NHIRD, 271 had been diagnosed with VI. Risk factors for poor prognosis and the crude hazard ratio was 3.004 (95% confidence interval 2.135–4.121, <i>p</i> < 0.001). Participants with VI had an increased risk of poor prognosis according to the sensitivity analysis, with a poor prognosis within the first year and first five years. VI was associated with suicide and mental health risks. This study revealed that patients with VI have a nearly 3-fold higher risk of psychiatric disorders, including anxiety, depression, bipolar, and sleep disorders, than the general population. Early detection through comprehensive examinations based on increased awareness in the clinical context may help maintain visual function and avoid additional complications.https://www.mdpi.com/2227-9032/11/10/1462vision lossNational Health Insurance Research Databaseretrospective cohort studyall-cause mortalitysuicidepoor prognosis |
| spellingShingle | Chieh Sung Chi-Hsiang Chung Fu-Huang Lin Wu-Chien Chien Chien-An Sun Chang-Huei Tsao Chih-Erh Weng Daphne Yih Ng A Population-Based Cohort Study of the Association between Visual Loss and Risk of Suicide and Mental Illness in Taiwan Healthcare vision loss National Health Insurance Research Database retrospective cohort study all-cause mortality suicide poor prognosis |
| title | A Population-Based Cohort Study of the Association between Visual Loss and Risk of Suicide and Mental Illness in Taiwan |
| title_full | A Population-Based Cohort Study of the Association between Visual Loss and Risk of Suicide and Mental Illness in Taiwan |
| title_fullStr | A Population-Based Cohort Study of the Association between Visual Loss and Risk of Suicide and Mental Illness in Taiwan |
| title_full_unstemmed | A Population-Based Cohort Study of the Association between Visual Loss and Risk of Suicide and Mental Illness in Taiwan |
| title_short | A Population-Based Cohort Study of the Association between Visual Loss and Risk of Suicide and Mental Illness in Taiwan |
| title_sort | population based cohort study of the association between visual loss and risk of suicide and mental illness in taiwan |
| topic | vision loss National Health Insurance Research Database retrospective cohort study all-cause mortality suicide poor prognosis |
| url | https://www.mdpi.com/2227-9032/11/10/1462 |
| work_keys_str_mv | AT chiehsung apopulationbasedcohortstudyoftheassociationbetweenvisuallossandriskofsuicideandmentalillnessintaiwan AT chihsiangchung apopulationbasedcohortstudyoftheassociationbetweenvisuallossandriskofsuicideandmentalillnessintaiwan AT fuhuanglin apopulationbasedcohortstudyoftheassociationbetweenvisuallossandriskofsuicideandmentalillnessintaiwan AT wuchienchien apopulationbasedcohortstudyoftheassociationbetweenvisuallossandriskofsuicideandmentalillnessintaiwan AT chienansun apopulationbasedcohortstudyoftheassociationbetweenvisuallossandriskofsuicideandmentalillnessintaiwan AT changhueitsao apopulationbasedcohortstudyoftheassociationbetweenvisuallossandriskofsuicideandmentalillnessintaiwan AT chiherhweng apopulationbasedcohortstudyoftheassociationbetweenvisuallossandriskofsuicideandmentalillnessintaiwan AT daphneyihng apopulationbasedcohortstudyoftheassociationbetweenvisuallossandriskofsuicideandmentalillnessintaiwan AT chiehsung populationbasedcohortstudyoftheassociationbetweenvisuallossandriskofsuicideandmentalillnessintaiwan AT chihsiangchung populationbasedcohortstudyoftheassociationbetweenvisuallossandriskofsuicideandmentalillnessintaiwan AT fuhuanglin populationbasedcohortstudyoftheassociationbetweenvisuallossandriskofsuicideandmentalillnessintaiwan AT wuchienchien populationbasedcohortstudyoftheassociationbetweenvisuallossandriskofsuicideandmentalillnessintaiwan AT chienansun populationbasedcohortstudyoftheassociationbetweenvisuallossandriskofsuicideandmentalillnessintaiwan AT changhueitsao populationbasedcohortstudyoftheassociationbetweenvisuallossandriskofsuicideandmentalillnessintaiwan AT chiherhweng populationbasedcohortstudyoftheassociationbetweenvisuallossandriskofsuicideandmentalillnessintaiwan AT daphneyihng populationbasedcohortstudyoftheassociationbetweenvisuallossandriskofsuicideandmentalillnessintaiwan |