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[www.ireachcontent.com] Patients with Diabetic Retinopathy Need Psychiatric Assessment and Management

Last updated :2016-08-30

Source: http://www.ireachcontent.com/news-releases/patients-with-diabetic-retinopathy-need-psychiatric-assessment-and-management-591146911.html

BALTIMORE, Aug. 24, 2016 /PRNewswire-iReach/ -- Depression in patients with diabetic retinopathy, one of the most common microvascular complications of diabetes, is not uncommon and can have a negative effect on diabetic retinopathy. Because of this, Xiaohong Chen, M.D., co-author of "Depression in Diabetic Retinopathy: A Review and Recommendation for Psychiatric Management," recommends that all vision-threatened patients with diabetic retinopathy receive psychological assessments in addition to conventional diabetic retinopathy therapy. The article was published in Psychosomatics, the Journal of the Academy of Psychosomatic Medicine.

"Early diagnosis of depression for patients with diabetic retinopathy is an important step toward better treatment," says Dr. Chen, Fundus Diseases Department, Zhongshan Ophthalmic Center, Sun Yat-Sen University, China. "That means that both ophthalmologists and psychiatric physicians should be aware of the risk factors so that they can better identify potential or existing depression patients with diabetic retinopathy." Among those risk factors are being female, having a low income, suffering from vision loss, and having a laser treatment history.

"Major depression contributes to the progression of diabetic retinopathy primarily in two ways, one is the direct way of vision impairment through biologic pathways," said Dr. Chen. The possible biologic mechanisms include circulating cytokines; insulin deficiency; chronic hyperglycemia and occurrence of iatrogenic hypoglycemia; hyperactivity of the hypothalamic-pituitary-adrenal axis; and impact on retinal vessels.

In addition, a negative attitude toward medication and surgical treatment due to depression also worsens the condition of retinopathy in an indirect way. "Timely management of depression helps to improve medication adherence and healthy behaviors, leading to better glycemic control and prognosis for retinopathy." said Dr. Chen.

"The introduction of depression screening into daily clinical practice, the training of experienced professionals to identify mental status, teaching programs, and conference discussions are all effective ways to help work out personalized treatment plans for this group of patients," the Psychosomatics article concluded.

The Academy of Psychosomatic Medicine, a professional society of more than 1,200 leading physicians, represents psychiatrists dedicated to the advancement of medical science, education, and health care for persons with co-morbid psychiatric and general medical conditions.