Relationship Between Legal Blindness and Depression

The higher prevalence rates of depression in visually-impaired individuals than the general population indicates that the condition per se increases the risk of depression. A person that is aware of the progressive loss of visual acuteness may have feelings of insecurity, anxiety, loss of independence and changes in social functioning, leading to depression. Several studies assessing the association between depressive symptoms and severity of vision loss have yielded inconsistent results. Some do not show any association, whereas others reported that depression severity is higher in those with substantial vision loss. The general aim of this manuscript was to determine the prevalence of depression in patients diagnosed with legal blindness in the Eye Care Service at the Hospital Córdoba between June 2016 and June 2017. The study sample consisted of 41 patients. The level of depression was assessed using the Zung scale and the degree of dependence in daily life activities was defined using the Barthel index. Data was anonymized for inclusion in a computer database and statistical confidentiality was protected. Data was analyzed using InfoStat statistical software. The results revealed a relation between legal blindness, degrees of dependency and depressive symptoms in patients of the Eye Care Service of the Hospital Córdoba. It is very important for health professionals to be trained to detect early signs and symptoms of depression and have the necessary tools for such an approach. Epub: October 1, 2019

Relationship Between Legal Blindness and Depression

The higher prevalence rates of depression in visually-impaired individuals than the general population indicates that the condition per se increases the risk of depression. A person that is aware of the progressive loss of visual acuteness may have feelings of insecurity, anxiety, loss of independence and changes in social functioning, leading to depression. Several studies assessing the association between depressive symptoms and severity of vision loss have yielded inconsistent results. Some do not show any association, whereas others reported that depression severity is higher in those with substantial vision loss. The general aim of this manuscript was to determine the prevalence of depression in patients diagnosed with legal blindness in the Eye Care Service at the Hospital Córdoba between June 2016 and June 2017. The study sample consisted of 41 patients. The level of depression was assessed using the Zung scale and the degree of dependence in daily life activities was defined using the Barthel index. Data was anonymized for inclusion in a computer database and statistical confidentiality was protected. Data was analyzed using InfoStat statistical software. The results revealed a relation between legal blindness, degrees of dependency and depressive symptoms in patients of the Eye Care Service of the Hospital Córdoba. It is very important for health professionals to be trained to detect early signs and symptoms of depression and have the necessary tools for such an approach. Epub: October 1, 2019

Women's views and postpartum follow-up in the CHIPS Trial (Control of Hypertension in Pregnancy Study).

OBJECTIVE: To compare women's views about blood pressure (BP) control in CHIPS (Control of Hypertension In Pregnancy Study) (NCT01192412). DESIGN: Quantitative and qualitative analysis of questionnaire responses. SETTING: International randomised trial (94 sites, 15 countries). POPULATION/SAMPLE: 911 (92.9%) women randomised to 'tight' (target diastolic blood pressure, 85mmHg) or 'less tight' (target diastolic blood pressure, 100mmHg) who completed questionnaires. METHODS: A questionnaire was administered at ∼6-12 weeks postpartum regarding post-discharge morbidity and views about trial participation. Questionnaires were administered by the site co-ordinator, and contact was made by phone, home or clinic visit; rarely, data was collected from medical records. Quantitative analyses were Chi-square or Fisher's exact test for categorical variables, mixed effects multinomial logistic regression to adjust for confounders, and p<0.001 for statistical significance. NVivo software was used for thematic analysis of women's views. MAIN OUTCOME MEASURES: Satisfaction, measured as willingness to have the same treatment in another pregnancy or recommend that treatment to a friend. RESULTS: Among the 533 women in 'tight' (N=265) vs. 'less tight' (N=268) control who provided comments for qualitative analysis, women in 'tight' (vs. 'less tight') control made fewer positive comments about the amount of medication taken (5 vs. 28 women, respectively) and intensity of BP monitoring (7 vs. 17, respectively). However, this did not translate into less willingness to either have the same treatment in another pregnancy (434, 95.8% vs. 423, 92.4%, respectively; p=0.14) or recommend that treatment to a friend (435, 96.0% and 428, 93.4%, respectively; p=0.17). Importantly, although satisfaction remained high among women with an adverse outcome, those in 'tight' control who suffered an adverse outcome (vs. those who did not) were not consistently less satisfied, whereas this was not the case among women in 'less tight' control among whom satisfaction was consistently lower for the CHIPS primary outcome (p<0.001), severe hypertension (p≤0.01), and pre-eclampsia (p<0.001). CONCLUSIONS: Women in 'tight' (vs. 'less tight') control were equally satisfied with their care, and more so in the face of adverse perinatal or maternal outcomes

Influence of gestational age at initiation of antihypertensive therapy: Secondary analysis of CHIPS trial data (control of hypertension in pregnancy study).

For hypertensive women in CHIPS (Control of Hypertension in Pregnancy Study), we assessed whether the maternal benefits of tight control could be achieved, while minimizing any potentially negative effect on fetal growth, by delaying initiation of antihypertensive therapy until later in pregnancy. For the 981 women with nonsevere, chronic or gestational hypertension randomized to less-tight (target diastolic blood pressure, 100 mm Hg), or tight (target, 85 mm Hg) control, we used mixed-effects logistic regression to examine whether the effect of less-tight (versus tight) control on major outcomes was dependent on gestational age at randomization, adjusting for baseline factors as in the primary analysis and including an interaction term between gestational age at randomization and treatment allocation. Gestational age was considered categorically (quartiles) and continuously (linear or quadratic form), and the optimal functional form selected to provide the best fit to the data based on the Akaike information criterion. Randomization before (but not after) 24 weeks to less-tight (versus tight) control was associated with fewer babies with birth weight 48 hours (Pinteraction=0.354). For the mother, less-tight (versus tight) control was associated with more severe hypertension at all gestational ages but particularly so before 28 weeks (Pinteraction=0.076). In women with nonsevere, chronic, or gestational hypertension, there seems to be no gestational age at which less-tight (versus tight) control is the preferred management strategy to optimize maternal or perinatal outcomes