Self-help group for addressing depression and anxiety in the visually impaired. A Pilot Study

Emanuela Rellini, Valeria Silvestri, Margherita Guidobaldi, Simona Turco, Filippo Maria Amore, Stefania Fortini

Abstract


Background: This work describes a vision rehabilitation approach integrated with a self-help group, for psychological support of visually impaired people. The effectiveness and benefits of attending self- help group was analyzed in accordance to anxiety, depression symptoms and visual functions.


Methods: The study, an observational perspective non randomized, was done on 31 visually impaired subjects, 16 females and 15 males, with a mean age of 63.7. Visual acuity, reading speed, anxiety and depression levels were valued before and after self-help group.


Results: After the attending period of self-help group, a decrease to 0.74 LogMAR (± 0.3) and 1.08 LogMAR (± 0.3) for the best corrected visual acuity was registered for the best and the worst eye respectively (p>0.05). There were significant improvements in anxiety (p<0.01) and depression levels (p<0.01). The average reading rate increased to 61.7 (± 24.4) wpm (p<0.01), representing 23% improvement. We found that anxiety was significantly determinant on the reading speed (p=0.02).


Conclusion: The results of this preliminary study suggest that this innovative approach can enhance visual functions with an effect on self-efficacy, it can offer support to the patients to cope with the onset of depression and anxiety and it can be a tool to promote psychological and social welfare.

Keywords


Anxiety; Depression; Low vision; Self-Help group; Rehabilitation.

Full Text:

PDF

References


Albanesi, C. (2004). I gruppi di auto-aiuto. [Self help groups]. Carocci, Roma.

Barr, W, Hodge, S, Leeven, M, Bowen, L., Knox, P.C. (2012) Emotional Support and Counselling for people with visual impairment: Quantitative findings from a mixed methods pilot study. Counselling and Psychotherapy Research 12:294-302. https://doi.org/10.1080/14733145.2012.663776

Beck, A.T., Steer, R.A., Garbin, M.G. (1988). Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Clinical Psychology Review, 8, 77-100. https://doi.org/10.1016/0272-7358(88)90050-5

Beck, A.T., Ward, C.H., Mendelson, M., Mock, J., Erbaugh, J. (1961). An inventory for measuring depression. Archives Of General Psychiatry, 4, 561-579. https://doi.org/10.1001/archpsyc.1961.01710120031004.

Binns, A.M., Bunce, C., Dickinson, C., Harper, R. (2012). How effective is low vision service provision? A systematic review. Survey of Ophthalmology, 57(1), 34-65. https://doi.org/10.1016/j.survophthal.2011.06.006.

Brody, B.L., Gamst, A.C., Williams, R.A., Smith, P. W., Lau, D., Dolnak, M. H., Rapaport, R. M., Kaplan, S., Brown, M.D. (2002). Depression, visual acuity, comorbidity, and disability associated with age-related macular degeneration. Ophthalmology, 108 (10), 1893-1900. https://doi.org/10.1016/s0161-6420(01)00754-0

Brody, B.L., Roch-Levecq, A.C., Kaplan, R.M., Moutier, C., Stuart, I., Brown,M.D. (2006). Age-related macular degeneration: self-management and reduction of depressive symptoms in a randomized controlled study. American Journal of Geriatric Psychiatry, 54 (10), 1557–62.

Calandri E., Graziano F., Borghi M., Bonino S. (2016) Depressione e benessere psicologico in persone con sclerosi multipla: il ruolo dell’identità, del senso di coerenza e dell’autoefficacia [Depression and psychological well-being in people with multiple sclerosis: the role of identity, a sense of coherence and self-efficacy] Psicologia della Salute, 1: 49-66. https://doi.org/0.3280/PDS2016-001007

Calcaterra, V. (2013). Attivare e Facilitare gruppi di auto/mutuo aiuto. Erickson, Trento.

Casten, R., Rovner, B.W., Fontenot, J. (2016). Targeted vision function goals and use of vision resources in ophthalmology patients with age-related macular degeneration and comorbid depressive symptoms. Journal of Visual Impairment & Blindness, 110 (6), 413-424. https://doi.org/10.1177/0145482X1611000604

Choi, H.G., Lee, M.J., Lee, S.M. (2018). Visual impairment and risk of depression: A longitudinal follow-up study using a national sample cohort. Scientific Reports, 1, 2083. https://doi.org/10.1038/s41598-018-20374-5

Cimarolli, V.R., Boerner, K., Brennan-Ing, M., Reinhardt,J.P., Horowitz, A. (2012). Challenges faced by older adults with vision loss: a qualitative study with implications for rehabilitation. Clinical Rehabilitation, 26 (8), 748–757. https://doi.org/10.1177/0269215511429162

Cimarolli, V.R., Casten, R.J., Rovner, B.W., Heyl,V., Sörensen, S., Horowitz , A. (2016). Anxiety and depression in patients with advanced macular degeneration: current perspectives. Clinical Ophthalmology, 10, 55-63. https://doi.org/10.1080/14733145.2012.663776

Deemer, A.D, Massof, R.W., Rovner, B.W., Robin J. Casten, R.J., Piersol, C.V. (2017). Functional outcomes of the low vision depression prevention trial in age-related macular degeneration. Investigative Ophthalmology And Visual Science, 58 (3), 1514-1520. https://doi.org/10.1167/iovs.16-20001

Dell’Osbel, G. (1996). Introduzione. La condizione dei non vedenti: aspetti medico-epidemoliogici e socio assistenziali. In Calati, D. Vedere con la mente. Conoscenza, affettività, adattamento nei non vedenti. Franco Angeli Milano.

Filippello, P., Sorrenti, L., Larcan, R., & Rizzo, A. (2013). Academic underachievement, self-esteem and self-efficacy in decision making. Mediterranean Journal of Clinical Psychology, 1(3), 2-11. https://doi:10.6092/2282-1619/2013.1.934

Fortini, S., Rellini, E., Turco, S., Amore, F. (2018). Ipovisione e benessere psicosociale [Low vision and psychosocial well-being]. Oftalmologia Sociale, 1, 38-44.

Ghisi, M., Flebus, G.B., Montano, A., Sanavio, E., Sica, C. (2006). Beck Depression Inventory-II. Manuale italiano. Firenze: Organizzazioni Speciali.

Goldstein, J.E., Chun, M.W., Fletcher, D.C. (2014). Visual ability of patients seeking outpatient low vision services in the United States. JAMA Ophthalmology, 132 (10), 1169-77. https://doi.org/10.1001/jamaophthalmol.2014.1747

Grant, P., Seiple, W., Szlyk, J.P. (2011). Effect of depression on actual and perceived effects of reading rehabilitation for people with central vision loss. Journal of Rehabilitation Research and Development, 48 (9), 1101-1108. https://doi.org/10.1682/jrrd.2010.05.0080

Hans-Werner, W. (2013). The psychological challenge of late-life vision impairment: concepts, findings, and practical implications. Journal of Ophthalmology, 17, 278135. https://doi.org/10.1155/2013/278135

Heesterbeek,T.J., van der Aa, H.P.A., van Rens, G.H.M.B., et al. (2017). The incidence and predictors of depressive and anxiety symptoms in older adults with vision impairment: a longitudinal prospective cohort study. Ophthalmic Physiol Opt, 37 (4), 385-398. https://doi.org/10.1111/opo.12388

Hodge, S., Barr, W., Bowen, L., Leeven, M., Knox, P.C. (2013). Exploring the role of an emotional support and counselling service for people with visual impairments. British Journal of Visual Impairment, 31, 5-19. https://doi.org/10.1177/0264619612465168

Horowitz, A., Brennan, M., Reinhardt, J.P., Macmillant, T. (2006). The impact of assistive device use on disability and depression among older adults with age-related vision impairments. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 61(5), 274-80. https://doi.org/10.1093/geronb/61.5. s274.

Horowitz, A., Reinhardt, J.P., Kennedy, G.J. (2005). Major and subthreshold depression among older adults seeking vision rehabilitation services. American Journal of Geriatric Psychiatry, 13, 180–7. https://doi.org/10.1176/appi.ajgp.13.3.180

Kalafat, J., & Dehmer, J. (1993). A survey of statewide self-help groups for older persons who are visually impaired. Journal of Visual Impairment & Blindness, 87(4), 112-114. https://doi.org/10.1177/0145482X9308700407

Liotta, M. (2013). Relationship between temperament and anxiety disorders: a systematic review. Mediterranean Journal of Clinical Psychology, 1(1), 1-25. https://doi.org/10.6092/2282-1619/2013.1.897

Manna, G., Falgares, G., Ingoglia, S., Como, M. R., & De Santis, S. (2016). The relationship between self-esteem, depression and anxiety: Comparing vulnerability and scar model in the Italian context. Mediterranean Journal of Clinical Psychology, 4(3), 1-17. https://10.6092/2282-1619/2016.4.1328

Markowitz, S.N. (2006). Principles of modern low vision rehabilitation. Canadian Journal of Ophthalmology, 41(3), 289–312. https://doi.org/10.1139/I06-027

Mehta, K.M., Irani,L., Chaudhuri,I., Mahapatra,T., Schooley,J., Srikantiah,S., Abdalla,S.,Ward,V., Carmichael,S.L., Bentley,J., Creanga,A., Wilhelm,J., Tarigopula,U.K., Bhattacharya,D., Atmavilas,Y., Nanda,P., Weng,Y., Pepper,K.T., Darmstadt, G.L., and for the Ananya Study Group (2020). Health layering of self-help groups: impacts on reproductive, maternal, newborn and child health and nutrition in Bihar, India. Journal of global health, 10 (2), 1-16. https://doi.org/10.7189/jogh.10.021007

Milan Cuijpers, P., Donker, T., van Straten, A., Li, J., Andersson, G. (2010). Is guided self-help as effective as face-to-face psychotherapy for depression and anxiety disorders? A systematic review and meta-analysis of comparative outcome studies. Psychological Medicine, 40(12), 1943–1957. https://doi.org/10.1017/S0033291710000772

Moroianu, L. A., Motofei, I. G., Curis, C., Barbu, R. E., Toma, A., (2020). The Impact of anxiey and depression on the pediatric patients with diabetes, Mediterranean Journal of Clinical Psychology, 8(2), 1-19. https://doi.org/10.6092/2282-1619/mjcp-2435

Moschos, M., Nitoda, E., Lavaris, A. (2016). Estimation of depression prevalence in patients with Stargardt disease using PHQ-9 and Zung scores. European Journal of Ophthalmology, 26 (3), 268-272. https://doi.org/10.5301/ejo.5000700

Myles, L. A. M., Connolly, J., & Stanulewicz, N. (2020). The Mediating Role of Perceived Control and Desire for Control in the Relationship between Personality and Depressive Symptomology. Mediterranean Journal of Clinical Psychology, 8(3), 1-24. https://doi.org/10.6092/2282-1619/mjcp-2589

Rovner, B.W., Casten, R.J. (2002). Activity loss and depression in age-related macular degeneration. American Journal of Geriatric Psychiatry, 10 (3), 35–10. https://doi.org/10.1097/00019442-200205000-00010

Rovner, B.W., Casten, R.J. (2008). Preventing late-life depression in age-related macular degeneration. American Journal of Geriatric Psychiatry, 6, 454–459. https://doi.org/10.1097/JGP.0b013e31816b7342

Rovner, B.W., Casten, R.J., Hegel MT, et al. (2006). Minimal depression and vision function in age-related macular degeneration. Ophthalmology, 113, 1743–1747. https://doi.org/10.1016/j.ophtha.2006.05.033

Rovner, B.W., Casten, R.J., Massof, R.W. Leiby, B.E., Tasman, W.S., Wills, E. (2011). Psychological and cognitive determinants of vision function in age-related macular degeneration. Archives of Ophthalmology, 129 (7), 885- 890. https://doi.org/10.1001/archophthalmol.2011.146

Salzer, M.S., Rappaport, J., Segre, L. (2001). Mental health professionals' support of self-help groups. Journal of Community & Applied Social Psychology, 11(1), 1-10. https://doi.org/10.1002/casp.606

Schwarzer, R. (1992). Self-efficacy in the adoption and maintenance of health behaviors: Theoretical approaches and a new model. In R. Schwarzer (Ed.). Self-efficacy: Thought control of action. Hemisphere Publishing Corp.

Sheikh, S., Dahiya, S., Ansari, A. H., & Kumar, M. M. (2019). The association of quality of life between anxiety and depression in patients with chronic rheumatic heart disease. Mediterranean Journal of Clinical Psychology, 7(2). https://doi.org/10.6092/2282-1619/2019.7.2164

Sibilia, L., Schwarzer, R., Jerusalem, M. (1995). Italian Adaptation of the Generalized Self- Efficacy Scale. http://userpage.fu-berlin.de/~health/italian.htm

Thetford, C, Robinson, J., Knox, P., Mehta, J., Wong, D. (2011) Long-term access to support for people with sight loss. British Journal of Visual Impairment 29, 1-14. https://doi:10.1177/0264619610387889

Utoyo, D.B. (2015). Modifying Cognitive-Behavioral Therapy for a Depressed Older Adult With Partial Sight: A Case Report. Gerontology Geriatric Medicine, 1, 1-5. https://doi.org/10.1177/2333721415585432

van der Aa, H.P., Hoeben, M., Rainey, L., van Rens, G.H.M.B. (2015). Why visually impaired older adults often do not receive mental health services: the patient's perspective. Quality of Life Research, 24(4), 969-78. https://doi.org/10.1007/s11136-014-0835-0

World report on vision. World Health Organization (WHO). WHO 2019 Publication https://www.who.int/publications-detail/world-report-on-vision.

Zung, W.W. (1971). A rating instrument for anxiety disorders. Psychosomatics, 12 (6), 371-379. https://doi.org/10.1016/S0033-3182(71)71479-0




DOI: https://doi.org/10.6092/2282-1619/mjcp-2891

Refbacks

  • There are currently no refbacks.