Subtyping depression in the rheumatic diseases by cluster analysis.

IF 2.8 3区医学 Q2 RHEUMATOLOGY

Clinical Rheumatology Pub Date : 2025-07-21 DOI:10.1007/s10067-025-07586-7

Yaqi Zhao, Suyan Yan, Xinya Li, Wei Xu, Baocheng Liu, Zhenzhen Ma, Qingrui Yang

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Abstract

Objective: Major depressive disorder (MDD) and rheumatic diseases (RD) interact to exacerbate disease outcomes. The purpose of this study was to assess the prevalence and associated factors of depression in RD patients in order to identify independent predictors of mental health disorders risk and apply cluster analysis to identify homogeneous groups in a population of approximately 47 patients with RD-MDD to achieve precise treatment and early prevention of complications.

Methods: In total, 205 RD patients were included in this study. We used the Profile of Mood State (POMS) and Patient Health Questionnaire-9 (PHQ-9) to assess the patients' state of mind. A cluster analysis was applied according to six clinical and serological variables to define different subgroups of patients.

Results: The rate of depression in RD patients in our study was 22.9%. Sex (female), disease duration, and disease activity are risk factors for the development of depression. Albumin is a protective factor for MDD. RD-MDD patients were clustered in two groups. Cluster 1 (n = 30, 63.8%): patients were of older age, lower education and income levels, low disease activity, and mild depressive symptoms. Cluster 2 (n = 17, 36.2%): Young women with higher education and income levels, high disease activity, and more severe depressive symptoms.

Conclusion: Our findings provide evidence indicating that RD-MDD presents varying clinical phenotypes and the treatment varies accordingly, suggesting the need for individualized treatment. Key Points • Depression is often comorbid in patients with rheumatic diseases. The two interact and aggravate the patient's condition. • The rate of depression in RD patients in our study was 22.9%. Sex (female), disease duration, and disease activity are risk factors for the development of depression. Albumin is a protective factor for MDD. • RD-MDD patients were clustered in two groups through cluster analysis in order to guide individualized treatment.

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类风湿疾病抑郁亚型的聚类分析。

目的：重度抑郁障碍（MDD）和风湿病（RD）相互作用加剧疾病结局。本研究的目的是评估RD患者抑郁的患病率和相关因素，以确定精神健康障碍风险的独立预测因素，并应用聚类分析在大约47名RD- mdd患者中确定同质组，以实现精确治疗和早期预防并发症。方法：本研究共纳入205例RD患者。采用心境状态量表（POMS）和患者健康问卷-9 （PHQ-9）对患者的心理状态进行评估。根据6个临床和血清学变量进行聚类分析，确定患者的不同亚组。结果：本研究RD患者抑郁率为22.9%。性别（女性）、病程和疾病活动是抑郁症发生的危险因素。白蛋白是重度抑郁症的保护因子。RD-MDD患者分为两组。聚类1 (n = 30, 63.8%)：患者年龄较大，受教育程度和收入水平较低，疾病活动度低，抑郁症状较轻。聚类2 (n = 17, 36.2%)：受教育程度和收入水平较高、疾病活动性高、抑郁症状更严重的年轻女性。结论：我们的研究结果提供了证据，表明RD-MDD表现出不同的临床表型，治疗方法也相应不同，提示需要个体化治疗。抑郁症常在风湿病患者中合并症。两者相互作用，加重病人的病情。•在我们的研究中，RD患者的抑郁率为22.9%。性别（女性）、病程和疾病活动是抑郁症发生的危险因素。白蛋白是重度抑郁症的保护因子。•通过聚类分析将RD-MDD患者分为两组，以指导个体化治疗。

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来源期刊

Clinical Rheumatology 医学-风湿病学

CiteScore

6.90

自引率

2.90%

发文量

441

审稿时长

3 months

期刊介绍： Clinical Rheumatology is an international English-language journal devoted to publishing original clinical investigation and research in the general field of rheumatology with accent on clinical aspects at postgraduate level. The journal succeeds Acta Rheumatologica Belgica, originally founded in 1945 as the official journal of the Belgian Rheumatology Society. Clinical Rheumatology aims to cover all modern trends in clinical and experimental research as well as the management and evaluation of diagnostic and treatment procedures connected with the inflammatory, immunologic, metabolic, genetic and degenerative soft and hard connective tissue diseases.