Prevalence of Mental Health Illness among Patients with Adult-Onset Strabismus.

BACKGROUND

Children diagnosed with some forms of strabismus were recently found to have an increased risk of developing mental illness by early adulthood. The purpose of this case-controlled study was to determine if adults with non-paralytic forms of strabismus are similarly at an elevated risk for developing mental illness.

METHODS

The medical records of all patients diagnosed as adults (≥ 19 years of age) with convergence insufficiency (CI) (n = 118), divergence insufficiency (DI) (n = 80), and small angle hypertropia (HT (n = 99) from January 1, 1985, through December 31, 2004, were retrospectively reviewed. Each case was compared with a sex- and birth date-matched non-strabismic control. The medical records were reviewed for mental health diagnoses, including inpatient and outpatient encounters, psychiatric ER visits, and medication use.

RESULTS

Mental health disorders were diagnosed in 65 (55.1%) patients with CI compared to 54 (45.8%) controls (p = 0.15), in 51 (63.8%) patients with DI compared to 42 (52.5%) controls (p = 0.15), and in 63 (63.6%) patients with HT compared to 57 (57.6%) controls (p = 0.38). CI patients were not more likely to have mental health disorders than their controls (p = 0.15). Mental health hospitalizations (p = 0.02), psychiatric medication use (p = 0.04), and unspecified anxiety disorders (p = 0.03) were higher in DI patients compared to controls. HT patients were found to have more generalized anxiety disorders (p = 0.003) than controls.

CONCLUSIONS

Adults with some forms of strabismus (DI and HT) appear to have an increased risk of mental illness and its comorbidities, compared to age- and gender-matched non-strabismic controls.