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Study: Low vision interventions can prevent depression
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A study recently published in Ophthalmology found that combining low vision rehabilitation with mental health support halved the incidence of depression in patients with age-related macular degeneration.
In the Low Vision Depression Prevention Trial (VITAL), Rovner and colleagues evaluated the role of behavior activation and low vision rehabilitation compared to supportive therapy and low vision rehabilitation.
The single-masked, attention-controlled, randomized clinical trial included 188 participants with bilateral AMD and subsyndromal depressive symptoms, as detailed in the study.
Participants visited an optometrist twice, and the practitioner prescribed devices to help with low vision. Following this, participants were split into two groups in which one received behavioral activation and one received supportive therapy.
“Behavior activation involves helping people focus on activities they enjoy, recognize that loss of those activities can lead to depression and re-engage in those activities,” Robin Casten, PhD, a co-author and an associate professor of psychiatry and human behavior at Thomas Jefferson University in Philadelphia, said in a press release from the National Eye Institute, which funded the study.
Supportive therapy, the authors noted, included discussion of illness, disability and vision loss.
“Treatment facilitated personal expression about vision loss and disability and, in this trial, controlled for the nonspecific effects of attention,” they said.
Participants in both groups received six in-home 1-hour therapy sessions during a 1-month period.
Results showed that 23.4% of supportive therapy participants and 12.6% of behavior activation participants developed clinical depression.
The authors concluded that increased collaborations between optometry, ophthalmology, rehabilitation, behavioral psychology and psychiatry could improve care and outcomes for AMD patients.
“Stronger links between primary eye care and mental health care workers would be needed to make behavior activation more widely available for AMD patients,” Barry Rovner, MD, a professor of psychiatry and neurology at the Sidney Kimmel Medical College at Thomas Jefferson University, said in the release.
“We built this to be an affordable treatment. Now we would like to see it become accessible,” he continued. "The study is continuing to follow participants to see if the benefits of treatment are maintained out to 1 year."
Disclosure: The authors have no proprietary or commercial interest in any materials discussed in this article.
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Ophthalmology. 2014; doi: 10.1016/j.ophtha.2014.05.002.
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