Uveitis associated with elevated psychological stress

This cross-sectional, case-controlled study examined the association between uveitis and psychological stress.

Study design

Researchers recruited 80 patients with uveitis and 40 control patients who completed the Cohen 10-item Perceived Stress Scale (PSS-10), a self-administered survey to assess psychological stress. Each question was categorized on a 5-point Likert scale and the total scores ranged from 0 to 40 (no stress to high stress, respectively). Researchers also reviewed medical records and performed 3 salivary cortisol tests. Patients with uveitis were classified as recently active (within past 90 days) or controlled disease.

Outcomes

The mean PSS-10 score was higher by 4.3 points in the uveitis group compared with controls (P=0.002). Factors that were associated with higher PSS-10 scores in the uveitis group included female gender, use of immunomodulatory therapy, history of depression and diagnosis of posterior or panuveitis.

Patients with uveitis had significantly higher PSS-10 scores when the analysis controlled for presence of comorbid systemic autoimmune disease (P=0.01). Salivary cortisol levels did not differ between uveitis and non-uveitis patients, nor was there a difference in the PSS-10 scores of patients with active and controlled uveitis.

Limitations

The study is limited by its case-control study design. It shows an association but cannot determine whether stress is a cause or a result of uveitis. There was low adherence to salivary testing.

Clinical significance

This study suggests the presence of uveitis is associated with higher levels of psychological stress. As physicians, we should consider addressing this psychological stress in the care of uveitis patients.