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Boys With Intermittent Exotropia Appear More Likely to Develop Mental Illness CHICAGO -- June 8, 2009 -- Children, especially boys, diagnosed with intermittent exotropia appear more likely to develop mental illness by young adulthood than children without strabismus, according to a study published in the June issue of Archives of Ophthalmology. Jeff A. McKenzie, Mayo Clinic, Rochester, Minnesota, and colleagues analysed the medical records of 183 children aged younger than 19 years from Olmsted County, Minnesota, who were diagnosed with intermittent exotropia between 1975 and 1994. For each patient, the researchers identified 1 control child who was the same age but did not have a diagnosis of any type of strabismus. Both groups were followed to an average age of 22. During the 20-year study period, 97 of the children with intermittent exotropia (53%) were diagnosed with a mental health disorder, compared with 55 controls (30.1%). Mental health disorders were diagnosed in 63% of boys (41/65) and 47% of girls (56/118) with intermittent exotropia, compared with 33% of boys (22/66) and 28% of girls (33/117) in the control group. "Additionally, males with intermittent exotropia had a greater use of psychotropic medication, psychiatric emergency department visits, psychiatric hospital admissions, suicide attempts, and suicidal ideation than controls. Females with intermittent exotropia had more suicidal ideation than controls," the authors wrote. The reasons underlying these associations remain unclear, the authors note. "Studies regarding the psychosocial impact of strabismus have reported that individuals with intermittent exotropia are not judged more poorly than individuals with orthotropia by adult observers. However, a negative bias toward people with strabismus has been demonstrated in children," they wrote. "Although this study focused on mental illness that was diagnosed by early adulthood, there is also evidence to suggest that the social problems associated with strabismus persist and even intensify into adult life." "Further study is needed to determine whether interventions for intermittent exotropia can decrease or otherwise alter the future development of mental illness," they concluded. SOURCE: Archives of Ophthalmology E-mail this page to a friend or colleague! To print, use this version