通过聚类分析对风湿性疾病中的抑郁症进行亚型分类。
Subtyping depression in the rheumatic diseases by cluster analysis.
作者信息
Zhao Yaqi, Yan Suyan, Li Xinya, Xu Wei, Liu Baocheng, Ma Zhenzhen, Yang Qingrui
机构信息
Department of Rheumatology and Immunology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Department of Rheumatology and Immunology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
出版信息
Clin Rheumatol. 2025 Jul 21. doi: 10.1007/s10067-025-07586-7.
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.
目的
重度抑郁症（MDD）与风湿性疾病（RD）相互作用，会加剧疾病后果。本研究的目的是评估RD患者中抑郁症的患病率及相关因素，以确定心理健康障碍风险的独立预测因素，并应用聚类分析在约47例RD-MDD患者群体中识别同质组，从而实现精确治疗和并发症的早期预防。
方法
本研究共纳入205例RD患者。我们使用情绪状态量表（POMS）和患者健康问卷-9（PHQ-9）来评估患者的心理状态。根据六个临床和血清学变量进行聚类分析，以定义不同的患者亚组。
结果
我们研究中RD患者的抑郁症发生率为22.9%。性别（女性）、病程和疾病活动度是抑郁症发生的危险因素。白蛋白是MDD的保护因素。RD-MDD患者被聚类为两组。第1组（n = 30，63.8%）：患者年龄较大，教育和收入水平较低，疾病活动度低，抑郁症状较轻。第2组（n = 17，36.2%）：年轻女性，教育和收入水平较高，疾病活动度高，抑郁症状更严重。
结论
我们的研究结果提供了证据，表明RD-MDD呈现出不同的临床表型，治疗方法也相应不同，这表明需要个体化治疗。要点 • 抑郁症在风湿性疾病患者中常合并存在。两者相互作用并加重患者病情。 • 我们研究中RD患者的抑郁症发生率为22.9%。性别（女性）、病程和疾病活动度是抑郁症发生的危险因素。白蛋白是MDD的保护因素。 • 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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