The relationship between mental health symptoms and disease severity, and quality of life in chronic rhinosinusitis patients with nasal polyps: a latent profile analysis

To investigate the heterogeneity of mental health among patients of chronic rhinosinusitis with nasal polyps (CRSwNP), and further look into the relationship between mental health, disease severity, and quality of life. Patients with CRSwNP were investigated using the General information questionnaire, Lund-Mackay score (LMS), 22-item Sino-Nasal Outcomes Test (SNOT-22), 14-item Perceived Stress Scale (PSS-14), as well as Hospital Anxiety and Depression Scale (HADS). Latent profile analysis was applied to investigate the heterogeneity of mental health in CRSwNP patients. Multivariate logistic regression was utilized to analyze the influencing factors of different profiles. 185 patients with CRSwNP were enrolled, including 105 males (56.8%) and 80 females (43.2%), and mean (SD) age was 46.31 (14.41). Three potential profiles of mental health were identified, including ‘positive group’ (30.3%), ‘stable group’ (30.8%), and ‘negative group’ (38.9%). Disease severity was associated with different groups of mental health. Patients with higher disease severity and having a history of systemic steroid use are more likely to be categorized in the ‘stable group’ and ‘negative group’. The total scores and various domains (rhinology symptoms, extra-nasal rhinologic symptoms, ear/facial symptoms, psychological dysfunction, and sleep dysfunction) scores of quality of life are significantly different among the groups. Three potential profiles of mental health in patients of CRSwNP were identified. Severity contributes to the heterogeneity of mental health, and quality of life is associated with mental health. Clinical caregivers could give targeted interventions to improve patients’ quality of life through characteristics of mental health and severity.本研究旨在探讨慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）患者心理健康的异质性，并进一步分析心理健康与疾病严重程度、生活质量之间的关联。研究采用一般情况调查问卷、伦德-麦凯评分（Lund-Mackay score, LMS）、22项鼻腔鼻窦结局测试（SNOT-22）、14条目感知压力量表（PSS-14）以及医院焦虑抑郁量表（HADS）对慢性鼻-鼻窦炎伴鼻息肉患者进行调查。采用潜在剖面分析探究该类患者心理健康的异质性，并利用多因素logistic回归分析不同亚组的影响因素。本研究共纳入185例慢性鼻-鼻窦炎伴鼻息肉患者，其中男性105例（占比56.8%），女性80例（占比43.2%），平均年龄为46.31岁（标准差14.41）。研究共识别出3种潜在心理健康亚组，分别为"积极组"（占比30.3%）、"稳定组"（占比30.8%）以及"消极组"（占比38.9%）。疾病严重程度与不同心理健康亚组存在关联；疾病严重程度较高、有全身糖皮质激素使用史的患者更易被归为"稳定组"与"消极组"。各组患者的生活质量总分及各维度（鼻腔症状、鼻外鼻窦症状、耳/面部症状、心理功能障碍及睡眠功能障碍）评分均存在显著差异。本研究明确了慢性鼻-鼻窦炎伴鼻息肉患者存在3种潜在心理健康亚组，疾病严重程度是心理健康异质性的影响因素，且生活质量与心理健康水平密切相关。临床医护人员可根据患者的心理健康特征与疾病严重程度，开展针对性干预以提升患者的生活质量。