Depressive symptoms among the visually disabled in Wuhan: an epidemiological survey

BACKGROUND: There are no representative studies on the mental health status of persons with disabilities in China. OBJECTIVE: Estimate the prevalence of depressive symptoms and identify the factors associated with depressive symptoms in a representative sample of individuals with serious visually disabilities in Wuhan, China. METHODS: A multi-stage stratified cluster sampling method was used to identify 1200 visually disabled individuals from among the 22,000 persons with serious visual disabilities who were registered with the Wuhan Disabled Persons' Federation. Identified individuals were administered the Center for Epidemiological Studies Depression Scale (CES-D) and the Revised Eysenck Personality Questionnaire-Short Scale for Chinese (EPQ-RSC) by trained interviewers. RESULTS: The adjusted prevalence of mild, moderate and severe depressive symptoms among the 1003 individuals who successfully completed the survey were 8.8% (95% confidence interval [CI]=5.7-11.8%), 15.6% (CI=12.8-18.5%) and 16.0% (CI=13.7-18.3%), respectively. Factors significantly associated with more severe depressive symptoms in the multivariate logistic regression analysis (in order of importance) were emotional instability (OR=5.84, CI=4.19-8.14), introverted personality (OR=2.94, CI=2.10-4.12), having religious beliefs (OR=2.03, CI=1.06-3.90), being blind (versus those who were only visually impaired) (OR=1.52, CI=1.09-1.95), being unmarried (OR=1.51, CI=1.06-2.15), and having limited education (OR=1.49, CI=1.06-2.10). CONCLUSIONS: Over one-third of all individuals with visual disabilities registered with the Disabled Persons' Federation in in Wuhan have clinically significant depressive symptoms. Almost none of these individuals receive treatment. Services for persons with serious visual disabilities – and for individuals with other types of serious physical or sensory disabilities – should include activities aimed at improving psychological wellbeing, periodic screening for psychological problems and, when needed, professional treatment for mental disorders.