Depression Subtypes in Individuals With or at Risk for Symptomatic Knee Osteoarthritis

Abstract

Objective. The present study was undertaken to identify depression subtypes in individuals with or at risk for symptomatic knee osteoarthritis (OA) and to evaluate differences in pain and disability trajectories between groups.Methods. Participants (n = 4,486) were enrolled in the Osteoarthritis Initiative. Latent class analysis was applied to the 20-item Center for Epidemiologic Studies Depression Scale measured at baseline to identify groups with similar patterns of depressive symptoms, and subtypes were assigned using posterior probability estimates. The relationships between depression subtypes and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and disability subscales were modeled over 4 years and stratified by baseline knee OA status (symptomatic [n = 1,626] or at risk [n = 2,860]).Results. Four subtypes were identified: asymptomatic (80.6%), catatonic (5.3%), anhedonic (10.6%), and melancholic (3.5%). Catatonic and anhedonic subtypes were differentiated by symptoms corresponding to psychomotor agitation and the inability to experience pleasure, respectively. The melancholic subtype expressed symptoms related to reduced energy and movement, anhedonia, and other somatic symptoms. Detectable mean differences in pain and disability compared to the asymptomatic group were observed for the anhedonic (1.5-2.3 WOMAC units) and melancholic (4.8-6.6 WOMAC units) subtypes, and associations were generally larger in individuals with symptomatic knee OA relative to those at risk.Conclusion. Among individuals with or at risk for symptomatic knee OA, there is evidence of depression subtypes characterized by distinct clusters of depressive symptoms that have differential effects on reports of pain and disability over time. Our findings thus imply that depression interventions could be optimized by targeting the specific symptomology that these subtypes exhibit.

The factor structure of major depressive symptoms in a sample of Chinese earthquake survivors

“…Third, the two-factor model could be better interpreted as different symptomatic representation and subtypes of MDD than the unidimensional model [ 50 , 51 ]. A number of empirical studies used machine learning, genetic, and biological approaches to yield strong evidence in favor of MDD consisting of somatic and affective/cognitive factors, rather than one “depression” factor [ 51 – 53 ]. It is interesting that the best fitting model in this study contradicted the results of Elhai et al (2012), Petersen et al (2015) and Mordeno et al (2018).…”

“…These findings provided evidence for the external validity of the distinction between the MDD somatic and non-somatic factors. Third, the two-factor model could be better interpreted as different symptomatic representation and subtypes of MDD than the unidimensional model [50,51]. A number of empirical studies used machine learning, genetic, and biological approaches to yield strong evidence in favor of MDD consisting of somatic and affective/cognitive factors, rather than one "depression" factor [51][52][53].…”

Association between severity of depressive symptoms and chronic knee pain in Korean adults aged over 50 years: a cross-sectional study using nationally representative data

“…Among previous studies, a cross-sectional study described the relationship between depressive symptoms and severity of chronic knee pain assessed by the Numerical Rating Scale (NRS) and the Kellgren-Lawrence Scale 15. Moreover, a recent study revealed a relationship between depressive symptom subtypes and risk for symptomatic knee pain 16…”

The relationship between mental health/physical activity and pain/dysfunction in working-age patients with knee osteoarthritis being considered for total knee arthroplasty: a retrospective study

“…An interesting recent study on individuals with or at risk for symptomatic KOA identified the following four subtypes of depression: asymptomatic, catatonic, anhedonic, and melancholic. Anhedonic and melancholic depression subtypes were suggested to be risk factors for increased pain and disability in individuals who developed and experienced symptomatic KOA [34]. Our results suggest that depression scores in working-age women were significantly correlated with preoperative pain and function, and this association was not reported in working-age men.…”