A study recently published in JAMA Network Open investigated the association between visual impairment (VI) and suicide.
Give me some background first.
More than 500 million people experience blindness or vision impairment worldwide—conditions that have also been linked to mental health and quality of life issues.
Case in point: Past studies have displayed possible associations between vision impairment and increased risk of suicide (see here, here and here).
Go on…
However, with previous research displaying inconsistency in association levels, investigators here conducted a systematic review and meta-analysis to evaluate both the association and potential risk factors.
Now, talk about the study.
A systematic review of literature took place to identify relevant studies to pull from databases, with the search date ranging from the inception of the databases to Feb. 4, 2024. Researchers pulled from the following databases:
- PubMed
- EMBASE
- Scopus
- The Cochrane Library
What was the criteria for study inclusion?
The database studies were evaluated for inclusion based on the following criteria:
- Population-based
- Reporting VI as a covariate
- Incorporating suicide death, suicidal ideation, or suicide attempts as outcome measures
- Providing odds ratios (ORs) or relative risks (RRs) ) with corresponding 95% CIs as measures of association
After review and criteria were applied, 31 studies were selected, comprising a total of 5,692,769 participants.
Findings?
A total of 17 studies investigated VI and suicidal behavior, and patients with VI were almost 2.5x more likely to have this behavior—with an odds ratio (OR) of 2.49 (95% CI, 1.71-3.63).
Meanwhile, 21 studies examined VI and suicidal ideation—with an OR of 2.01 (95% CI, 1.62-2.50), displaying that patients with VI were 2x more likely to experience suicidal ideation.
Go on…
Patients with VI displayed a 1.89x greater likelihood of suicide death, with eight studies assessing this [OR = 1.89 (95% CI, 1.32-2.71)]. These findings displayed associations between VI and suicidal behavior, ideation, and death.
In addition, a subgroup analysis on age was also run and participant age was identified as an additional risk factor. Studies focused on adolescents displayed the highest risk of suicidal behavior.
Limitations?
In addition to heterogeneity within the populations, there was a possibility of bias relating to self-reported vision and additional confounding risk factors, all leading to future research being warranted.
Expert opinion?
Per the authors of the study: “It is recommended that clinicians remain attentive to the elevated risk and be ready to implement suitable suicide prevention measures when required, especially when dealing with adolescents.”
Take home.
Although further research will need to be conducted, the authors noted that these associations display a greater emphasis on the importance of eye health to overall mental health.