# Exploring Subtypes Based on Depression and Anxiety in Preoperative Patients With Carpal Tunnel Syndrome: A Two-Step Cluster Analysis

## TL;DR

This study identifies subtypes of carpal tunnel syndrome patients based on depression and anxiety levels before surgery, showing that psychological factors correlate with disability severity.

## Contribution

The novel contribution is the use of cluster analysis to classify CTS patients into subgroups based on preoperative depression and anxiety, highlighting their impact on disability.

## Key findings

- Three patient subgroups were identified: psychologically normal, only depression, and psychologically impaired.
- The psychologically impaired group showed significantly higher upper extremity disability compared to other clusters.

## Abstract

Background

Although a growing body of literature supports the importance of depression and anxiety, the assessment of these modifiable factors has not been considered in recent clinical practice guidelines for patients with carpal tunnel syndrome (CTS). This study aimed to classify patients with CTS into preoperative subgroups using cluster analysis based on the Japanese versions of the Self-Rating Depression Scale (SDS) and Pain Anxiety Symptom Scale-20 (PASS-20). Outcome measures were also compared for each cluster.

Methods

Data from 65 patients with CTS were analyzed. The SDS and PASS-20 psychological parameters were grouped using the K-means cluster method, according to Ward’s method. Sociodemographic, disease-related, physical, psychological, and disability outcomes were compared between the clusters.

Results

A three-cluster solution, which categorized patients into “psychologically normal,” “only depression,” and “psychologically impaired” clusters, was selected. Upper extremity disability in the “psychologically impaired” cluster was more severe compared to that in other clusters.

Conclusions

We provided evidence for the detection of depression and anxiety in patients with CTS at a preoperative period.