Dry eye disease (DED) is a multifactorial ocular surface disorder. The disease seriously affects the quality of life of patients. In recent years, the bidirectional relationship between DED and psychological factors such as anxiety, depression, stress and sleep disorders is increasingly receiving attention. This article systematically reviews the interaction between DED and psychological factors as well as its underlying mechanisms. Based on the Psycho-Neuro-Endocrino-Immune (PNEI) network, the roles of autonomic nervous system dysregulation, central sensitization, inflammatory pathways and neuroendocrine dysfunction are focused. Furthermore, the emerging concept of the Brain-Gut-Eye Axis is examined as a frontier perspective. Based on the comprehensive diagnosis and treatment strategy of the " bio-psycho-social" medical model, suggestions of multidisciplinary diagnosis and treatment under the integrated medical model are proposed. This may provide new ideas for precise combination therapy.