Experts' perspectives on the impact of visual impairment and comorbid mental disorders on functioning in essential life domains.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968559 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-244X (Electronic) Linking ISSN: 1471244X NLM ISO Abbreviation: BMC Psychiatry Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Autism Spectrum Disorder*/epidemiology ; Psychotic Disorders*/epidemiology ; Obsessive-Compulsive Disorder*/diagnosis ; Mental Disorders*/complications ; Mental Disorders*/epidemiology ; Mental Disorders*/therapy; Humans ; Female ; Middle Aged ; Male ; Mental Health ; Vision Disorders/complications ; Vision Disorders/epidemiology ; Comorbidity

Background: Visual impairment (VI) with comorbid mental disorders (MDs) are expected to have a major impact on people's daily functioning, for which tailored support is needed. However, this has been barely investigated. Therefore, this study aimed to (1) determine the impact of VI and comorbid MDs on functioning in essential life domains, (2) gain insight into best-practices that are currently used to support this target group, and (3) determine strategies to optimize care in the future.
Methods: A four-step qualitative Delphi method was used to obtain input from 31 Dutch professionals who work with this target group (84% female, mean age 46 years, on average 11 years of experience in working with the target group). The Self-Sufficiency Matrices were used to determine the impact on various aspects of daily living, for people with VI and (1) autism spectrum disorder, (2) psychotic disorders, (3) obsessive-compulsive disorder, (4) antisocial personality disorder, (5) borderline personality disorder, (6) dependent personality disorder.
Results: Experts describe a frail and vulnerable population, in which the VI and MD often have a cumulative negative impact on people's physical and mental health. People frequently experience anxiety, depression, fatigue and sleep disturbances. Also, many tend to neglect self-care and substance abuse is common. They often experience difficulty in trusting others while at the same time being dependent on them. Social interaction and relationships are complicated because of communication restrictions (e.g. no facial recognition) and social incompetence or withdrawal. Experts advise taking transdiagnostic factors into account, using evidence-based psychological treatment options based on an intermittent approach, and offering multidisciplinary care. They stress the importance of building trust, showing patience and empathy, stimulating empowerment, involving the informal network and building on positive experiences.
Conclusion: VI and comorbid MD have a major impact on people's daily functioning on a mental, physical, social and environmental level. This study provides insight into best-practices to support this target group. According to experts, more research is needed which could be aimed at investigating tailored diagnostic approaches and treatment options and include clients' perspectives.
(© 2024. The Author(s).)

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NJ2017-04 Programmaraad Visueel; NJ2017-04 Programmaraad Visueel; NJ2017-04 Programmaraad Visueel

Keywords: Antisocial personality disorder; Autism spectrum disorder; Borderline personality disorder; Comorbidity; Delphi; Dependent personality disorder; Functioning; Obsessive-compulsive disorder; Psychotic disorders; Visual impairment

Date Created: 20240319 Date Completed: 20240320 Latest Revision: 20240321

20240321

PMC10946163

10.1186/s12888-024-05635-0

38500080