Latent class analysis of depressive and anxious symptoms among Chinese rheumatoid arthritis patients

Abstract

Background: Depression and anxiety create additional burdens for adults with rheumatoid arthritis (RA), negatively affecting disease outcomes and quality of life. Therefore, this study aims to identify symptom patterns of depression and anxiety and explore the influencing factors; In addition, we want to investigate the relationships among different symptom profiles and quality of life in Chinese RA patients. Methods: A total of 355 RA patients (including 293 females, age = 55.05 ± 13.04 years) were recruited in this study. Depression and anxiety symptoms were assessed using the Hospital Anxiety and Depression Scale. We applied latent class analysis to identify distinct symptom subgroups of depression and anxiety in RA patients. The latent class subtypes were compared using the One-way ANOVA or chi-square test. Multinomial logistic regression was performed to examine associations between identified classes and related factors. Results: We identified 3 distinct symptom patterns or classes in this study, including the high depressive and anxious symptoms, the moderate depressive and anxious symptoms and the mild anxiety symptoms. The number of RA patients in each class is 131, 72 and 152 respectively. The multinomial logistic regression revealed that compared with the mild anxiety symptoms group, the associated factors of depression and anxiety in other two subgroups were pain and functional capacity. Additionally, we found that different symptom profiles were significantly associated with quality of life in Chinese RA patients. Conclusions: As is known to us, this is the first latent class analysis that categorized the symptom subgroups of depression and anxiety in Chinese RA patients. Our findings suggested that the main factors influencing the high and moderate depressive and anxious symptoms groups are pain and functional capacity and different symptom profiles were significantly associated with quality of life. Rheumatologists and nurses should provide targeted psychological interventions according to different symptom patterns to promote the quality of life among RA patients.