Non-infectious Uveitis is Associated With Increased Psychiatric Comorbidities: An All of Us research program Analysis.

Abstract

This study aims to evaluate the psychiatric comorbidities of non-infectious uveitis (NIU) and screening tool usage through a matched case-control approach. Retrospective cross-sectional study. Patients with NIU and without NIU were chosen from the All of Us database with consent and information provided via electronic health records. The All of Us database was searched for NIU cases using International Classification of Diseases (ICD) and Systematized Nomenclature of Medicine (SNOMED): ICD10CM-H44.13 and SNOMED 128473001, and matched controls (1:3). Comorbidity frequencies for NIU patients (n = 3,266) and case controls (n = 9,798), and PHQ screening tool usage were recorded. Case controls were matched across all demographic variables offered through All of Us: race, age, sex, ethnicity, smoking status, and social determinants of health including employment status, income, education, and insurance status. Wald's test logistic regression compared both groups (P<0.05). Frequency of psychiatric comorbidities in NIU patients and control patients, including across race. Frequency of mental health screening usage among NIU patients. Psychiatric diseases were selected for analysis based on their pertinence to psychiatric health and were among the few that were sufficiently powered from the possible comorbidities in the All of Us database. NIU patients had higher frequency of personality disorder (5.2%, OR 3.74 [2.97-4.75]), mood disorder (46.4%, OR 3.31 [3.08-3.56]), depressive disorder (44.0%, OR 3.34 [3.10-3.60]), anxiety (44.3%, OR 3.13 [2.92-3.37]), insomnia (25.3%, OR 2.93 [2.60-3.30]), substance abuse (16.1%, OR 2.34 [2.05-2.67]), schizophrenia (3.0%, OR 2.38 [1.70-3.31]), bipolar disorder (7.8%, OR 2.16 [1.81-2.60]), and opioid abuse (3.0%, OR 2.06 [1.59-2.69]) (P < 0.05, all). The association between NIU and depression, anxiety, substance and opioid abuse was stronger in Black participants than White participants. The frequency of PHQ-2 and PHQ-9 questionnaire usage was low among NIU patients with a total of 4.8% and 1.4% respectively. NIU is strongly associated with psychiatric comorbidities, particularly in Black patients. Ophthalmologic examination and the use of screening tools for psychiatric comorbidities can provide early observation of symptoms and is recommended in NIU patients.