The association between personality and dry eye disease: A large cross-sectional study

Purpose: Personality influences health and wellbeing. The purpose of this large, cross-sectional study was to clarify the association between personality traits and dry eye disease (DED). 

Methods: 78,610 participants from the Lifelines cohort were included. DED was assessed using the Women's Health Study (WHS) dry eye disease questionnaire. Three of the Big Five personality domains (neuroticism, extraversion, conscientiousness) were assessed using an abbreviated NEO Personality Inventory. Logistic regressions including age, sex, BMI, physical activity, smoking, education, income, and 48 medical comorbidities were used to examine the association between personality and DED. The main outcome was WHS-defined DED, with highly symptomatic DED as a secondary outcome. Results are presented as odds ratios per standard deviation increase in personality score. 

Results: DED was present in 8.7 % of participants. In the fully corrected model including all demographics and comorbidities, higher neuroticism was associated with greater odds of DED (OR 1.10, P < 0.001), while higher conscientiousness was tied to lower odds of DED (OR 0.97, P = 0.014). For highly symptomatic DED, these associations were especially strong: OR 1.23 (P < 0.001) and 0.90 (P < 0.001) for neuroticism and conscientiousness, respectively. Higher extraversion was associated with lower odds of highly symptomatic DED (OR 0.93, P = 0.031), but showed no significant relationship with WHS-defined DED. Additionally, participants diagnosed with DED who had higher neuroticism scores experienced a greater symptom burden. 

Conclusions: Higher neuroticism and lower conscientiousness are associated with increased odds of DED. These personality traits may contribute to increased subjective symptoms and are important to consider in clinical management and care.