Depression and Anxiety Reduce the Probability of Achieving a State of Sustained Minimal Disease Activity in Patients With Psoriatic Arthritis
Bibliographic record
Abstract
OBJECTIVE: We aimed to determine whether the presence of depression or anxiety is associated with the achievement of sustained minimal disease activity (MDA) in patients with psoriatic arthritis (PsA). METHODS: Adult patients satisfying classification criteria for PsA prospectively followed from 2008 to 2017 were included. A standard protocol including physician assessment and patient-reported outcomes determined whether patients achieved sustained MDA, which was defined as meeting MDA criteria for ≥2 consecutive visits. The presence of depression/anxiety was determined using 3 definitions: 1) a score of ≤38 on the mental component summary of the Medical Outcomes Study Short Form 36 (SF-36) health survey, 2) a score of ≤56 on the mental health domain of the SF-36 health survey, and 3) a rheumatologist's report of a diagnosis or treatment for depression/anxiety. A discrete time-to-event analysis was conducted based on a proportional odds model to identify factors associated with achieving sustained MDA. RESULTS: A total of 743 patients were included in the study. The number of patients identified as having depression/anxiety at baseline included 331 patients (44.54%) according to definition 1, 364 patients (48.99%) according to definition 2, and 211 patients (28.4%) according to definition 3. A total of 337 patients (45.36%) did not achieve sustained MDA. The presence of depression/anxiety was associated with reduced probability of achieving sustained MDA, with odds ratio (OR) 0.30 (P < 0.0001), OR 0.34 (P < 0.0001), and OR 0.47 (P < 0.0001) for definitions 1, 2, and 3, respectively. Other variables associated with a reduced probability of achieving sustained MDA included the Charlson comorbidity index and fibromyalgia. CONCLUSION: Symptoms of anxiety/depression reduce the probability of achieving sustained MDA in PsA. Comprehensive management of PsA should include measures for addressing these comorbidities.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".