Role of Psychological Stress in Noninfectious Uveitis

Abstract Background: Psychological stress has been shown to be associated with the etiopathogenesis of several autoimmune diseases. Uveitis can be a sight-threatening disease if not treated promptly and adequately. There are limited data on the potential association between psychological stress and noninfectious or autoimmune uveitis, particularly from the Indian subcontinent. The aim of our study was to evaluate the role of psychological stress in noninfectious uveitis. Methodology: This was a prospective, single-center, cross-sectional study. Sixty-three patients with noninfectious uveitis (Group 1 – 32 patients with recently active uveitis in Group 1A and 31 patients with inactive uveitis in Group 1B) and 63 age- and gender-matched patients without uveitis (Group 2), who met the eligibility criteria, were enrolled. Psychological stress was assessed in all participants using the 10-item version of Cohen Perceived Stress Scale (PSS-10). The main outcome measure was the comparison of mean stress scores between the groups and subgroups. Results: This study found significantly higher levels of psychological stress in patients with uveitis (13.92 ± 4.48 vs. 12.24 ± 2.79, P = 0.01). This was significantly higher in patients with recently active uveitis compared to both nonuveitis controls (15.81 ± 4.90 vs. 12.24 ± 2.79, P < 0.001) and patients with inactive uveitis (15.81 ± 4.90 vs. 11.97 ± 2.96, P < 0.001). A significantly higher number of patients in the recently active uveitis group reported stressful life events within a 6-month period prior to presentation, compared to both the nonuveitis control group ( P = 0.01) and the inactive uveitis group ( P = 0.04). Disease-related stress was reported by patients in both the recently active uveitis and inactive uveitis groups. Conclusions: This study highlights the significant association of psychological stress with both the cause and the effect of the disease in patients with noninfectious uveitis. It is important to identify and address psychological stress in patients with uveitis for their holistic care and management.