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

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.