Psychosocial predictors of treatment adherence and quality of life among patients with uveitis in a tertiary care hospital, Riyadh, Saudi Arabia
Abdulrahman F. Albloushi, Nawaf M. Alsanea, Abdullah F. Aldayel, Nawaf S. Alghamdi, Abdulrahman Y. Alhoumaily, Fahad D. AlosaimiAbstract
Purpose
To assess the prevalence of treatment adherence and quality of life among patients with uveitis, and to examine the influence of psychosocial predictors including depressive symptoms, anxiety symptoms and adult attachment style on these outcomes.
Methods
An analytical cross‐sectional study was conducted at the uveitis outpatient clinics in King Saud University Medical City in Riyadh between December 2024 and July 2025. Adult patients aged 18 years or older with a confirmed diagnosis of uveitis were eligible for inclusion. Patients completed a self‐administered Arabic electronic questionnaire including validated instruments: the Generalized Anxiety Disorder‐7 (GAD‐7) for anxiety, Patient Health Questionnaire‐9 (PHQ‐9) for depression, Visual Function Index‐14 (VF‐14) for quality of life, Modified Experiences in Close Relationships Scale (ECR‐M16) for attachment style, and a Visual Analog Scale (VAS) for medication adherence.
Results
Among the 248 participants, 199 (80.2%) were adherent to treatment. A significant association was observed between non‐adherence to medication and depression ( p = 0.041). Depression and anxiety were identified in 27% and 23.8% of participants, respectively. The median VF‐14 score was 92.9 (IQR: 77.3–98.2). 22.6% attributed uveitis to psychological stress and 16.1% to supernatural causes like the evil eye, magic or jinn possession, and 34.3% used ruqyah (faith healing) as a treatment. In bivariate analysis, age, educational level, marital status, employment, anxiety and depression were significantly associated with quality of life. In the multivariable model, only university education ( β = 13.09, 95% CI: 4.25–21.93; p = 0.004) and depression ( β = −8.58, 95% CI: −13.83 to −3.33; p = 0.001) remained independently associated with quality of life. In multivariable analysis for medication adherence, depression, anxiety, use of ruqyah and alternative medicine are significant predictors for medication adherence.
Conclusion
Our findings demonstrate that depression and lower educational level were independently associated with reduced vision‐related quality of life. In the multivariable adherence model, depression and alternative medicine use were associated with lower adherence, while anxiety and ruqyah use were associated with higher adherence. Further studies are encouraged to assess the effectiveness of routine psychosocial screening and the application of integrated multidisciplinary care in patients with uveitis.