{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T23:48:27Z","timestamp":1771544907365,"version":"3.50.1"},"reference-count":46,"publisher":"Wiley","license":[{"start":{"date-parts":[[2018,5,29]],"date-time":"2018-05-29T00:00:00Z","timestamp":1527552000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Ophthalmology"],"published-print":{"date-parts":[[2018,5,29]]},"abstract":"<jats:p><jats:italic>Purpose<\/jats:italic>. To assess the psychological status of keratoconus sufferers and to determine the relationship between depression and visual impairment in this group of patients. <jats:italic>Methods<\/jats:italic>. Fifty-six patients with keratoconus and forty-seven age- and gender-matched healthy control subjects were retroprospectively analyzed. Every participant underwent a complete ophthalmological examination. Keratoconus diagnosis was confirmed with corneal topography and tomography. Zung Depression Inventory Questionnaire and Patient Health Questionnaire-9 (PHQ-9) were completed by everyone. <jats:italic>Results<\/jats:italic>. Visual acuity (logMAR 0.53\u2009\u00b10.30 versus 0.11\u2009\u00b1\u20090.16), PHQ-9 score (10.20\u2009\u00b1\u20094.00 versus 5.40\u2009\u00b1\u20095.01), and Zung score (46.52\u2009\u00b1\u20098.70 versus 38.53\u2009\u00b1\u20098.41) showed a statistically significant difference between keratoconus patients and healthy controls (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mrow><mml:mi>p<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:mrow><\/mml:math> for all). Worse visual acuity was strongly correlated with older individuals (rho\u2009=\u20090.339, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mrow><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.011<\/mml:mn><\/mml:mrow><\/mml:math>) and higher PHQ-9 (rho\u2009=\u20090.765, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\"><mml:mrow><mml:mi>p<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:mrow><\/mml:math>) and Zung score (rho\u2009=\u20090.672, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\"><mml:mrow><mml:mi>p<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:mrow><\/mml:math>). <jats:italic>Conclusion<\/jats:italic>. Depressive disorders appear to be directly associated with keratoconus, both in frequency and intensity. Worse visual acuity and older age could be identified as predictive factors for their emotional status. Moreover, the disease itself could be recognized as an independent risk factor for depression development, underlying the need for close monitoring and supportive management. To the best of our knowledge, our study is the first in the literature to elaborate the association between keratoconus and depression, by assessing two different questionnaires simultaneously.<\/jats:p>","DOI":"10.1155\/2018\/7314308","type":"journal-article","created":{"date-parts":[[2018,5,29]],"date-time":"2018-05-29T19:31:34Z","timestamp":1527622294000},"page":"1-5","source":"Crossref","is-referenced-by-count":35,"title":["Psychological Aspects and Depression in Patients with Symptomatic Keratoconus"],"prefix":"10.1155","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3361-9523","authenticated-orcid":true,"given":"Marilita M.","family":"Moschos","sequence":"first","affiliation":[{"name":"1st Department of Ophthalmology, Medical School of University of Athens, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4154-1597","authenticated-orcid":true,"given":"Nikolaos 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Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitrios","family":"Ladas","sequence":"additional","affiliation":[{"name":"1st Department of Ophthalmology, Medical School of University of Athens, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Tsatsos","sequence":"additional","affiliation":[{"name":"Royal Eye Infirmary, Dorset County Hospital, Dorchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8523-1024","authenticated-orcid":true,"given":"Irini","family":"Chatziralli","sequence":"additional","affiliation":[{"name":"1st Department of Ophthalmology, Medical School of University of Athens, Athens, 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