TOPLINE

Noninfectious uveitis was linked to markedly higher rates of various psychiatric conditions, with Black patients disproportionately affected, an analysis of a nationwide US cohort reported. Despite this elevated psychiatric burden, mental health screening was rarely performed, with fewer than 5% of patients completing Patient Health Questionnaires (PHQs).

METHODOLOGY

• Researchers conducted a retrospective cross-sectional study using electronic health records from the nationwide All of Us Research Program (May 2018 to June 2024) to determine the prevalence of psychiatric comorbidities in patients with noninfectious uveitis and how often those patients received mental health screening.
• A total of 3266 patients with noninfectious uveitis (mean age, 61.4 years; 61.3% women) were identified using standard diagnostic codes and matched with 9798 control individuals without the condition.
• Frequencies of psychiatric comorbidities — including personality, mood, depressive, and anxiety disorders; insomnia; substance and opioid abuse; schizophrenia; and bipolar disorder — were reported before the diagnosis of uveitis and at several timepoints afterward.
• The use of the PHQ-2 and PHQ-9 screening tools in patients with noninfectious uveitis was examined to determine how often the tools were administered and what proportion of screened patients had a psychiatric diagnosis.

TAKEAWAY

• Noninfectious uveitis was associated with significantly higher frequencies of psychiatric conditions — personality disorder (odds ratio [OR], 3.74), mood disorder (OR, 3.31), depressive disorder (OR, 3.34), anxiety (OR, 3.13), insomnia (OR, 2.93), substance abuse (OR, 2.34), schizophrenia (OR, 2.38), bipolar disorder (OR, 2.16), and opioid abuse (OR, 2.06; P < .05 for all) — and these elevations persisted after excluding patients with preexisting psychiatric diagnoses.
• Black participants with noninfectious uveitis had significantly higher frequencies of depression (P = .02), anxiety (P < .0001), substance abuse (P = .0004), and opioid abuse (P = .01) than White participants with the condition.
• Most psychiatric comorbidities were diagnosed at least 1 year after the diagnosis of uveitis; visual function impairment was significantly greater in participants with uveitis than in those without uveitis across all psychiatric comorbidities.
• Mental health screening was rarely used in noninfectious uveitis — fewer than 5% received PHQ-2, and only 1.4% received PHQ-9; roughly one third of participants taking the PHQ-2 had anxiety or depression, whereas about three quarters of those taking the PHQ-9 had depression or mood disorder.

IN PRACTICE

Increased mental health screening and ophthalmologic examination in patients with noninfectious uveitis “should be encouraged, especially in medically underserved populations,” the researchers reported.

SOURCE

The study was led by Priya Marella, MBA, of the Institute of Ophthalmology and Visual Science at Rutgers New Jersey Medical School in Newark, New Jersey. It was published online on July 20 in American Journal of Ophthalmology.

LIMITATIONS

The study could not prove cause and effect between noninfectious uveitis and mental health problems, so it was unclear whether the eye condition led to these issues or the other way around. The database also did not show which type of clinician had given the mental health questionnaires — ophthalmologists or psychiatrists — making it hard to judge screening practices across specialties.

DISCLOSURES

This study did not receive any funding. No relevant conflicts of interest or competing interests were disclosed by the authors.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.