{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:15:07Z","timestamp":1785402907327,"version":"3.56.0"},"reference-count":23,"publisher":"Royal College of Psychiatrists","issue":"6","license":[{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec id=\"S2056472425108703_as1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mental health disorders such as depression and anxiety are highly prevalent among ophthalmic patients, particularly those with progressive vision impairment. Despite the strong interconnection between mental health and vision-related disabilities, mental health support remains underintegrated into ophthalmic care. The economic burden of untreated mental health conditions in visually impaired patients is understudied, particularly in middle-income countries such as Turkey and Bulgaria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472425108703_as2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study aims to examine the economic impact of untreated mental health disorders among ophthalmic patients, focusing on financial burden, healthcare access disparities and quality of life outcomes. In addition, the study compares barriers to mental healthcare across ophthalmic conditions and between Turkey and Bulgaria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472425108703_as3\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A qualitative study was conducted using structured surveys and in-depth interviews with 214 ophthalmic patients (107 in Turkey, 107 in Bulgaria). Mental health symptoms were assessed using the Patient Health Questionnaire-9 (for depression) and Generalized Anxiety Disorder-7 (for anxiety) scales. Thematic analysis was applied to qualitative responses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472425108703_as4\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over 50% of participants exhibited moderate-to-severe depression and anxiety, with diabetic retinopathy and retinal disease patients experiencing the highest distress levels. Financial barriers were more pronounced in Bulgaria, whereas long psychiatric wait times disproportionately affected retinal patients. Mental health stigma was higher in Bulgaria, limiting care access.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472425108703_as5\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Findings underscore the urgent need for integrating mental health services into ophthalmic care. Policy interventions should focus on financial support, stigma reduction and improved interdisciplinary care models to enhance mental health outcomes for visually impaired individuals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjo.2025.10870","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T06:51:42Z","timestamp":1760683902000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Beyond vision: economic toll of untreated mental health disorders in ophthalmic patients"],"prefix":"10.1192","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3120-8782","authenticated-orcid":false,"given":"Cansu","family":"Y\u00fcksel Elgin","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01dzn5f42","id-type":"ROR","asserted-by":"publisher"}],"name":"Istanbul University-Cerrahpasa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8796-2429","authenticated-orcid":false,"given":"Ceyhun","family":"Elgin","sequence":"additional","affiliation":[{"name":"Bogazici University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2025,10,17]]},"reference":[{"key":"S2056472425108703_ref7","doi-asserted-by":"publisher","DOI":"10.1159\/000316688"},{"key":"S2056472425108703_ref4","doi-asserted-by":"publisher","DOI":"10.1177\/0145482X0810201003"},{"key":"S2056472425108703_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2021.100852"},{"key":"S2056472425108703_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31612-X"},{"key":"S2056472425108703_ref16","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0312475"},{"key":"S2056472425108703_ref18","doi-asserted-by":"publisher","DOI":"10.1080\/09286586.2023.2172189"},{"key":"S2056472425108703_ref8","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2020.4524"},{"key":"S2056472425108703_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2007.11.017"},{"key":"S2056472425108703_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2023.07.005"},{"key":"S2056472425108703_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(16)30024-4"},{"key":"S2056472425108703_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61817-6"},{"key":"S2056472425108703_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2007.04.048"},{"key":"S2056472425108703_ref23","first-page":"1","article-title":"Using Twitter to assess stigma to schizophrenia and psychosis","volume":"20","author":"Kara","year":"2023","journal-title":"Psychiatry Investig"},{"key":"S2056472425108703_ref22","doi-asserted-by":"publisher","DOI":"10.1167\/tvst.11.10.6"},{"key":"S2056472425108703_ref21","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61238-0"},{"key":"S2056472425108703_ref2","doi-asserted-by":"publisher","DOI":"10.15252\/embr.201642951"},{"key":"S2056472425108703_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(17)30293-0"},{"key":"S2056472425108703_ref6","doi-asserted-by":"publisher","DOI":"10.29245\/2578-2959\/2021\/3.1256"},{"key":"S2056472425108703_ref1","volume-title":"World Mental Health Report: Transforming Mental Health for All","year":"2022"},{"key":"S2056472425108703_ref5","doi-asserted-by":"publisher","DOI":"10.5935\/0004-2749.20150051"},{"key":"S2056472425108703_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2015.06.003"},{"key":"S2056472425108703_ref11","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"S2056472425108703_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(99)90082-9"}],"container-title":["BJPsych Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2056472425108703","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T06:51:42Z","timestamp":1760683902000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2056472425108703\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,17]]},"references-count":23,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["S2056472425108703"],"URL":"https:\/\/doi.org\/10.1192\/bjo.2025.10870","relation":{},"ISSN":["2056-4724"],"issn-type":[{"value":"2056-4724","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,17]]},"assertion":[{"value":"\u00a9 The Author(s), 2025. Published by Cambridge University Press on behalf of Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e246"}}