Incidence, risk factors, and correlation with organ involvement of psychological disorders in patients with Sjögren’s syndrome

Table 1 Comparison of baseline characteristics between two groups, n (%)

Variable	Psychological disorder group (n = 156)	Non-psychological disorder group (n = 130)	Statistical value	P value
Demographic characteristics
Female	144 (92.3)	110 (84.6)	χ² = 4.58	0.032
Age (years, mean ± SD)	52.8 ± 12.4	48.6 ± 11.7	t = 2.84	0.005
Disease duration (years, mean ± SD)	6.8 ± 4.2	4.9 ± 3.1	t = 4.32	< 0.001
BMI (kg/m2, mean ± SD)	22.6 ± 3.4	23.1 ± 3.2	t = 1.25	0.213
Socioeconomic status
Retired or unemployed	71 (45.5)	42 (32.3)	χ² = 5.59	0.018
Household monthly income < 5000 yuan	60 (38.5)	35 (26.9)	χ² = 5.11	0.024
Rural residence	64 (41.0)	37 (28.5)	χ² = 5.46	0.019
Education level ≤ junior high school	89 (57.1)	68 (52.3)	χ² = 0.68	0.410
Lifestyle factors
Smoking history	24 (15.4)	11 (8.5)	χ² = 4.13	0.042
Drinking history	20 (12.8)	13 (10.0)	χ² = 0.63	0.426
Disease-related factors
Family history of autoimmune diseases	36 (23.1)	18 (13.8)	χ² = 4.65	0.031
Number of comorbidities (n, mean ± SD)	2.3 ± 1.4	1.6 ± 1.1	t = 4.52	0.001
Oral and ocular dryness as initial symptoms	120 (76.9)	83 (63.8)	χ² = 6.98	0.008
Time from symptom onset to diagnosis (years, mean ± SD)	3.2 ± 2.8	2.1 ± 1.9	t = 3.78	0.003
Annual healthcare visits (times, mean ± SD)	8.6 ± 4.2	5.9 ± 3.1	t = 5.94	< 0.001
Marital status
Married	134 (85.9)	115 (88.5)	χ² = 0.47	0.495
Single/divorced/widowed	22 (14.1)	15 (11.5)

BMI: Body mass index.

Table 2 Incidence and related characteristics analysis of psychological disorders in patients with Sjögren’s syndrome, n (%)

Variable	Psychological disorder group (n = 156)	Non-psychological disorder group (n = 130)	Statistical value	P value
Distribution of psychological disorder types
Pure depression	58 (20.3)
Pure anxiety	38 (13.3)
Depression-anxiety comorbidity	60 (21.0)
Psychological assessment scale scores (mean ± SD)
HAMD score (points)	14.7 ± 6.2	3.2 ± 2.1	t = 22.15	< 0.001
HAMA score (points)	12.3 ± 5.8	2.8 ± 1.9	t = 19.84	< 0.001
Severity of psychological disorders
Mild	89 (31.1)
Moderate	46 (16.1)
Severe	21 (7.3)
Severity of depression
Mild depression	69 (58.5)
Moderate depression	35 (29.7)
Severe depression	14 (11.9)
Severity of anxiety
Mild anxiety	54 (55.1)
Moderate anxiety	32 (32.7)
Severe anxiety	12 (12.2)
Demographic characteristics
Female	144 (92.3)	110 (84.6)	χ² = 4.15	0.042
Age ≥ 50 years	107 (68.6)	64 (49.2)	χ² = 11.07	0.001
Age (years, mean ± SD)	52.8 ± 12.4	48.6 ± 11.7	t = 3.84	< 0.001
Disease characteristics
Disease duration ≥ 5 years	102 (65.4)	62 (47.7)	χ² = 9.18	0.002
Disease duration (years, mean ± SD)	6.8 ± 4.2	4.9 ± 3.1	t = 4.52	< 0.001

HAMD: Hamilton Depression Rating Scale; HAMA: Hamilton Anxiety Rating Scale.

Table 3 Comparison of organ involvement rates between psychological disorder and non-psychological disorder groups

Organ involvement	Psychological disorder group (n = 156) (%)	Non-psychological disorder group (n = 130) (%)	P value
Arthritis/arthralgia	56.4	38.5	0.003
Parotid gland swelling	42.3	26.9	0.009
Hematological abnormalities	31.4	18.5	0.008
Tubulointerstitial nephritis	18.6	9.2	0.015
Interstitial lung disease	18.5	13.8	0.002
Peripheral neuropathy	16.8	7.8	0.002
Cutaneous vasculitis	15.4	6.9	0.019

P < 0.05 for all comparisons between groups.

Table 4 Correlation between psychological disorder severity and clinical parameters in the psychological disorder group

Variable (X)	Variable (Y)	Pearson r	P value
HAMD score	ESSDAI score	0.678	< 0.001
HAMA score	ESSDAI score	0.542	< 0.001
Number of organs involved	Psychological disorder severity	0.625	< 0.001
Disease duration (years)	Psychological disorder severity	0.589	< 0.001
ESR level (mm/h)	Psychological disorder severity	0.667	0.002
Annual healthcare visits	Psychological disorder severity	0.612	< 0.001

r: Pearson correlation coefficient. All analyses performed in the psychological disorder group (n = 156). HAMD: Hamilton Depression Rating Scale; HAMA: Hamilton Anxiety Rating Scale; ESSDAI: European League Against Rheumatism Sjögren’s Syndrome Disease Activity Index.