Personality Traits in Keratoconus May Reveal Neurotic Temperament

Personality traits in keratoconus may involve neurotic temperament, psychosomatic symptoms, and coping mechanism dysfunction, according to research published in Cornea. The report suggests that clinicians take the mental and emotional state of these patients into consideration when providing care.  

Researchers enrolled 60 participants, including patients with keratoconus (n=30; 36.7% women; mean age, 23.8 years) and age- and sex-matched control group individuals (n=30; 43.3% women; mean age, 23.8 years) in a prospective, interventional, case-control study to determine personality traits in keratoconus. Participants underwent ocular examination, including anterior corneal surface keratometry, corneal topography, and anterior segment-optical coherence tomography (AS-OCT).

Participants completed the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) and underwent psychiatric assessment, which included the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (SCID-5), Symptom Checklist-90-Revised (SCL-90), Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Modified (TEMPS-M), and the NEO Five-Factor Inventory (NEO-FFI) to determine personality traits in keratoconus. 

Patients with keratoconus reported a lower quality of life compared with control group participants, as demonstrated by lower scores in all NEI VFQ-25 subdomains. A total of 9 patients with keratoconus (30.0%) were diagnosed with at least 1 cluster C personality disorder (anxious or fearful thinking) according to SCID-5 criteria — a 9-fold increased risk compared with control group participants. 

Among patients with keratoconus with a cluster C personality disorder, 88.9% were classified as having obsessive-compulsive disorder and 11.1% had avoidant personality disorder. Questionnaires revealed that personality traits in keratoconus included an increased risk for mood and anxiety disorders (risk ratio, 2.3 and 1.3, respectively), but these values failed to attain statistical significance. (P =.1172 and P =.7177, respectively).

“Our data underline the urgency of providing medical care to patients with [keratoconus] that does not end with the management of the ocular disease alone,” according to the researchers. “In fact, the high levels of psychological distress typical of patients with [keratoconus] may exert a predominant effect on the quality of life and significantly affect the social and working spheres.”

Study limitations include a case-control design, the exclusion of a subgroup, small sample size, and ethnic homogeneity which may have limited the globalization of these findings.