Depression is associated with non‐alcoholic fatty liver disease among adults in the United States

Kim, Dong‐Hee; Yoo, Eric R.; Li, Andrew A.; Tighe, Sean; Cholankeril, George; Harrison, Stephen A.

doi:10.1111/apt.15395

Cited by 75 publications

(75 citation statements)

References 44 publications

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“…Patients with significant fibrosis also employed maladaptive strategies, such as disengagement, to a greater extent in comparison with NASH patients without significant fibrosis, and fewer adaptive strategies such as active coping or acceptance. The results for mental health confirm the relationship between fibrosis and depression already noted previously by Weinstein et al (15), Youssef et al (7), and Tomeno et al (16) and therefore contradict the conclusion of Kim et al (17). In brief, the main findings of this study verified that there are differences in the QoL, mental health, and coping strategies of NAFLD patients depending on the perceived social support and histological fibrosis and confirm that the relevant variables predicting a worse disease-specific QoL in these patients are significant fibrosis, female sex, greater anxiety and depressive symptoms, and worse physical and mental health-related QoL.…”

Section: Cope-28supporting

confidence: 73%

“…In addition, the relationship between fibrosis and mental health in NAFLD patients is not clear either. Several studies have found an association between the presence of fibrosis and anxiety and depressive symptoms (7,15,16), while Kim et al (17) found no relationship. Furthermore, female sex has been associated with a worse physical and mental QoL than does male sex (2,18).…”

Section: Introductionmentioning

confidence: 96%

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Psychological Biomarkers and Fibrosis: An Innovative Approach to Non-alcoholic Fatty Liver Disease

et al. 2020

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Background: It is unknown how perceived social support and the progression of liver damage influence the psychosocial profile of patients with non-alcoholic fatty liver disease (NAFLD). In the present study, we therefore investigated which biomarkers influence the quality of life, mental health, and coping strategies of NAFLD patients. Methods: Quality of life (SF-12 and CLDQ-NAFLD), mental health (HADS and BDI-II), and coping strategies (COPE-28) were evaluated by high or low perceived social support (MSPSS) and the presence of non-alcoholic steatohepatitis (NASH) and significant fibrosis in 492 biopsy-proven NAFLD patients. The results were compared with quality of life normality tables for the general Spanish population. We also determined whether liver histology and biopsychosocial variables predicted participants' quality of life. Results: Interactive effects were found in vitality (p = 0.05), activity (p = 0.005), anxiety (p = 0.04), and denial (p = 0.04), with NASH patients showing a higher-risk biopsychosocial profile when they perceived less social support. Furthermore, patients with low perceived social support showed lower quality of life, worse mental health, and more maladaptive coping than those with high perceived social support, regardless of NASH presence. Patients with significant fibrosis showed lower quality of life compared to those without or the general Spanish population. Patients with significant fibrosis also reported worse mental health and more maladaptive coping. Lastly, significant fibrosis, female sex, greater anxiety and depressive symptoms, and worse physical and mental health-related quality of life were found to be independent determinants of worse disease-specific quality of life in these patients. Conclusions: Low perceived social support, significant fibrosis, and female sex were independently associated with a higher-risk psychosocial profile in NAFLD. These findings support the role of psychological biomarkers based on quality of life, mental health, and coping strategies in the management of these patients and suggest the potential benefits of a psychological intervention.

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Section: Cope-28supporting

confidence: 73%

Section: Introductionmentioning

confidence: 96%

Psychological Biomarkers and Fibrosis: An Innovative Approach to Non-alcoholic Fatty Liver Disease

et al. 2020

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“…(14) Another recently published study derived from the NHANES database demonstrated an association between NAFLD and the prevalence of depression. (11) On multivariate analysis, a significant association between depression and NAFLD defined by ultrasound but also with the hepatic steatosis index was observed in this cohort study. (11) The current large-scale analysis confirmed an independent impact of NAFLD on the incidence of depression in, to the best of our knowledge, the largest population-based cohort with a nationally representable sample of German adults.…”

Section: %supporting

confidence: 49%

“…(9,10) A recent study using the National Health and Nutrition Examination Survey (NHANES) observed an association between depression and NAFLD in the United States. (11) However, other recent studies produced conflicting evidence on the potential relation between NAFLD and depression. (12,13) Anxiety is another frequent psychiatric disorder in the Western world.…”

mentioning

confidence: 99%

Nonalcoholic Fatty Liver Disease Increases the Risk of Anxiety and Depression

et al. 2020

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Nonalcoholic fatty liver disease (NAFLD), depression, and anxiety disorders are frequent diseases, and data on mutual influence are inconsistent. The aim of this study was to explore the incidence of depression and anxiety in a large primary care cohort in Germany and to study the impact of NAFLD over a 10‐year time frame. Patients with NAFLD diagnosed between 2010 and 2015 were matched to a cohort without NAFLD controlling for age, sex, physician, index year, and Charlson comorbidity index. The primary outcome of the study was the incidence of depression, anxiety, and first prescription of antidepressant drugs. We compared 19,871 patients with NAFLD to 19,871 matched controls. Within 10 years of the index date, 21.2% of patients with NAFLD and 18.2% of controls were diagnosed with depression (P < 0.001). On regression analysis, the hazard ratio (HR) for incidence of depression was 1.21 (P < 0.001). This association was similar for the endpoint of the first prescription of antidepressant drugs (HR, 1.21; P < 0.001). Anxiety disorders were diagnosed in 7.9% of patients with NAFLD and 6.5% of controls during the observation time (P = 0.003). The HR for incidence of anxiety was 1.23 (P < 0.001). This association remained significant in women (P < 0.001), while there was only a trend in men (HR, 1.15; 95% confidence interval, 0.99‐1.34; P < 0.067). The risk of developing anxiety disorders was higher in younger patients. Conclusion: NAFLD constitutes an independent risk factor for emerging depression and anxiety even after controlling for confounding comorbidities.

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“…The recent study from Kim et al took a different approach with the NHANES database: the Fatty Liver Index, the hepatic steatosis index and the US Fatty Liver Index were used to identify patients with NAFLD, and FIB‐4 to stage the degree of fibrosis. Depression was present in over 10% of the entire cohort and shared risk factors with NAFLD.…”

mentioning

confidence: 99%