Analysis on the psychological characteristics of patients with acute iridocyclitis

Dear Sir,

I am Dr. Wei Sun, from the Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Shenyang 110005, Liaoning Province, China. I write to present our study on the psychological characteristics of patients with acute iridocyclitis.

Studies showed stimulation from patient's external environment could influence their psychological state, persisting neural endocrine disorders that might lead to a series of physiological and psychological changes in the human body^[1]–^[6]. It was confirmed many ocular diseases were related to psychological disorders, including cataracts, glaucoma, age-related macular degeneration, amblyopia, myopia, diabetic retinopathy, malignant tumors^[7]–^[14]. The appearance of these diseases could further aggravate mental states of patients that eventually formed a vicious cycle^[15],^[16].

Acute iridocyclitis was a common clinical disease. Patients in large numbers, with different variations, complicated etiology, and often recurrent flares would present^[17]. It was unclear if a patient's psychological condition could maintain a normal state during the protracted course of treatment in the past^[18]. This study was designed to investigate the psychological characteristics of patients with acute iridocyclitis.

A total of 105 patients and 100 normal individuals were involved in this study. The initial parameters were summarized in Tables 1, 2. Symptom checklist 90 (SCL-90), Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), and related psychological health questionnaires were utilized to evaluate all subjects. Differences between the two groups were compared with SPSS 17.0 statistics software using the t-test. P<0.05 was selected as the significance standard.

Table 1. The initial parameters of subjects.

Parameters	Group 1	Group 2
n	105	100
Sex (M:F)	37:68	30:70
Mean age (a)	35.64±11.32	38.25±9.44
Visual acuity	0.11±0.09	0.95±0.24
Mean duration	6.32±5.75d	None
Former medication	None	None
Big life events recently	None	None
Former psychological treatment	None	None

Group 1: Patients; Group 2: Normal subjects.

Table 2. Main complaint of the subjects.

Mean complaints	Group 1	Group 2
Mood low	38 (36.2)	6 (6)
Uncomfortability	19 (18.1)	9 (9)
Poor appetite	13 (12.4)	11 (11)
Fear	12 (11.4)	4 (4)
Insomnia	9 (8.6)	10 (10)
Others	14 (13.3)	60 (60)

n (%)

Results showed that the following characteristics are present in patients with acute iridocyclitis (Tables 3, 4). 1) Depression: the patients showed fragile psychology with waned interest, gloomy mood, and sullen expressions; 2) Compulsion: these patients were characterized by doing something repeatedly or thinking about something again and again; 3) Somatization: the patients frequently felt headaches, stomach-aches, or any other physical discomfort, sometimes noting a racing heartbeat while no actual disease exists; 4) Paranoia: the patients had auditory hallucinations. They often had self-accusatory tendencies or blame and had a sense of loneliness.

Table 3. Contrast of psychological state between patients with acute iridocyclitis (experimental group) and subjects without acute iridocyclitis (control group), using SCL90.

Projection	Group 1	Group 2	P
Somatizition	2.15±0.36	1.67±0.43	<0.05
Compulsion	2.44±0.79	1.72±0.46	<0.05
Hypersensitivity	1.69±0.58	1.64±0.55	>0.05
Depression	2.02±0.64	1.51±0.55	<0.05
Anxiety	1.39±0.48	1.37±0.44	>0.05
Hostility	1.36±0.56	1.37±0.54	>0.05
Fear	1.33±0.56	1.26±0.33	>0.05
Paranoia	1.36±0.49	1.41±0.58	>0.05
Psychopathy	1.85±0.47	1.34±0.51	<0.05

Group 1: Experimental group; Group 2: Control group.

x±s

Table 4. Contrast of psychological status between patients with and without acute iridocyclitis, using SDS and SAS.

Project	Group 1	Group 2	P
Self-rating anxiety scale	45.33±14.75	43.67±11.38	>0.05
Self-rating depression scale	53.55±15.68	43.15±14.95	<0.05

x±s

Results told us that we must pay attention to the following aspects during the therapy. 1) Improving communication skills of physicians. Patients came from different classes of society with varied values, age, occupation, cultural diversity, and comprehension levels^[19]. Therefore, excellent communication skills were valued to facilitate exchange the ideas and building rapport^[20]. 2) Providing guidance and excavating the root of disease^[21]. Doctors needed to listen to the story of the patients patiently, waiting for the opportunity to allow patients in understanding intensive changes of emotion can affect the source of disease. Emotional adjustment was an important method to treatment^[22]–^[24]. 3) Paying attention to the family of the patient. Keeping in touch with family members might not only be useful for the physiological and physiological health of the patient, but also direct influence on their family members, neighborhood, and even the entire society^[25].