Psychosocial interventions to improve mental health in adults with vision impairment: systematic review and meta-analysis

Purpose To systematically assess the literature on psychosocial interventions to improve mental health (i.e. depression, anxiety, mental fatigue, loneliness, psychological stress and psychological well‐being) in visually impaired adults (≥18 years). Methods The databases Medline, Embase and Psychinf...

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Bibliographic Details
Published in:Ophthalmic & physiological optics 2016-09, Vol.36 (5), p.584-606
Main Authors: van der Aa, Hilde P. A., Margrain, Tom H., van Rens, Ger H. M. B., Heymans, Martijn W., van Nispen, Ruth M. A.
Format: Article
Language:English
Subjects:
anxiety
depression
Humans
Mental Disorders - etiology
Mental Disorders - therapy
mental health
meta-analysis
Psychotherapy - methods
Randomized Controlled Trials as Topic
Stress, Psychological - etiology
Stress, Psychological - prevention & control
systematic review
Vision Disorders - psychology
vision impairment
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Summary:Purpose To systematically assess the literature on psychosocial interventions to improve mental health (i.e. depression, anxiety, mental fatigue, loneliness, psychological stress and psychological well‐being) in visually impaired adults (≥18 years). Methods The databases Medline, Embase and Psychinfo were searched for relevant studies, which were categorised into randomised controlled trials (RCTs), non‐RCTs and before and after comparisons (BA). The Cochrane Collaboration Risk of Bias Tool was used to assess study quality. Standardised mean differences (SMD) were calculated to quantitatively summarise the outcomes of the RCTs and non‐RCTs in a meta‐analysis. Meta‐regression was used to explore sources of heterogeneity in the data. Results The search identified 27 papers (published between 1981 and 2015), describing the outcomes of 22 different studies (14 RCTs, four non‐RCTs, and four BAs). Pooled analyses showed that interventions significantly reduced depressive symptoms (SMD −0.30, 95% confidence interval (CI) −0.60 to −0.01), while effects on anxiety symptoms, mental fatigue, psychological stress and psychological well‐being were non‐significant. Meta‐regression analyses showed homogeneity in effect sizes across a range of intervention, population, and study characteristics. Only a higher age of participants was associated with less effective results on depressive symptoms (b = 0.03, 95% CI 0.01 to 0.05), psychological stress (b = 0.07, 95% CI 0.01 to 0.13) and psychological well‐being (b = −0.03, 95% CI −0.05 to 0.01). However, after removing a clear outlier the overall effect on depressive symptoms and the influence of age on depressive symptoms and psychological stress were no longer significant, while the influence of age on psychological well‐being remained. Conclusions There is currently only limited evidence for the effectiveness of psychosocial interventions in the field of low vision. More well‐designed trials are needed with specific attention for interventions tailored to the needs of elderly patients.
ISSN:0275-5408
1475-1313
DOI:10.1111/opo.12313