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An investigation of the association between Retinitis pigmentosa (RP) and depressive disorder, including a call for practical training and methods.

Researchers at the Department of Ophthalmology, Ajou University School of Medicine, Suwon, Republic of Korea, have outlined an increasing future burden of depressive disorders, providing emotional and social support to patients with retinitis pigmentosa (RP).  The study, of almost 11,000 patients, showed that those diagnosed with RP had a higher risk of developing depressive disorder. Their findings support consideration of providing emotional and social support to patients with RP and, in a further commentary paper from Bascom Palmer Eye Institute, University of Miami, “developing practical training and methods feasible in today’s busy ophthalmic practice for recognizing and referring patients with depression is an important proactive step to improve patients’ quality of life”.

The researchers aimed to investigate the association between RP and depressive disorder using a retrospective, nationwide, population-based cohort study using data obtained from the Health Insurance Review and Assessment service in Korea. A total of 10,879 individuals who were newly diagnosed with RP over a 10-year study (between January 2011 and December 2021) followed the data, categorized into 3 groups based on age at diagnosis (<20 [638 patients], 20-39yr [2,233 patients], and ≥40 yr [8,008 patients]).  The 10-year cumulative incidence of depressive disorder was 17.67% (95% CI, 16.57%-18.84%) in patients with RP. Subgroup analysis showed higher incidence of depressive disorder in female patients (hazard ratio [HR], 1.46; 95% CI, 1.29-1.65; P < .001) and those aged 40 years or older (HR, 1.93; 95% CI, 1.63-2.29; P < .001). The overall incidence of depressive disorder in patients with RP was 1.19 (95% CI, 1.12-1.27; P < .001), indicating a higher risk of depressive disorder compared with that in the general population. Both male and female patients with RP showed increased incidence rates of depressive disorder (17.53 [95% CI, 15.91-19.27] and 25.57 [95% CI, 23.58-27.67] per 1,000 person-years, respectively).

Analyzing the data from the study, the 10-year estimated cumulative incidence of depressive disorder was approximately 18% in patients with RP without a prior diagnosis of depressive disorder, with a higher incidence in female patients and those aged 40 years or older.  In addition, the researchers also found that ~17.5% of patient with RP had already been diagnosed with depressive disorder before RP diagnosis. This suggests that approximately 35% of patients with RP may experience a depressive episode during their lifetime.  Potentially, every 3rd patient in the clinic may experience   a depressive episode during their lifetime.  As a result, the researchers commented that, given “the increasing emphasis on the management of depressive disorders, these findings suggest that providing emotional support or social assistance to patients with RP should be considered.” Given the progressive nature of the disorder over several decade, there is a clear demand in the clinic and a call for practical training and methods may be invaluable at the coalface.