Construction of a nomogram for anxiety and depression in patients with Sjögren's syndrome by combining tongue and pulse characteristics: a cross-sectional study based on a prospective cohort.

OBJECTIVE: To develop and validate a predictive model for predicting psychological complications of Sjögren's syndrome (SS) in combination with tongue and pulse characteristics. METHODS: This cross-sectional study was based on a prospective cohort study including SS patients recruited from 30 major tertiary hospitals in China. Nomograms were developed based on the clinical characteristics, tongue and pulse manifestations, and laboratory tests of these patients, and univariate and multivariate logistic regression analyses were used to screen for various correlates of anxiety and depression, and the column charts were evaluated using the area under the curve (AUC), calibration curves, and decision curve analysis. RESULTS: A total of 444 patients were included, comprising 424 females (95.5%) and 20 males (4.5%), with a mean age of (46 ± 13) years. The prevalence of anxiety and depression was 45.5% (n = 202) and 42.1% (n = 187), respectively. Peeled tongue was associated with higher rates of both anxiety and depression among SS patients [odds ratio (OR) for anxiety = 0.44, 95% CI (0.26, 0.74), P = 0.002; OR for depression = 0.44, 95% CI (0.27, 0.73), P = 0.002]. Regarding pulse diagnostics, a thready pulse was linked to increased anxiety [OR= 1.99, 95% CI(1.11, 3.60), P = 0.022], while a slippery pulse correlated with depression [OR = 0.32, 95% CI(0.14, 0.74), P = 0.007]. Nomograms developed from these findings demonstrated good predictive performance, with AUC values of 0.767 for anxiety and 0.741 for depression in both training and validation cohorts. CONCLUSIONS: Integrating Traditional Chinese Medicine diagnostics with conventional clinical assessments provides a robust predictive model for psychological comorbidities in SS. The innovative approach enhances personalized management, offering a pathway for targeted interventions to treat anxiety and depression effectively in affected patients.