Nonalcoholic Fatty Liver Disease Increases the Risk of Anxiety and Depression

Abstract

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.

Cognitive Dysfunction in Non-Alcoholic Fatty Liver Disease—Current Knowledge, Mechanisms and Perspectives

“…Specifically, fatigue, that is a common complaint among patients with NAFLD and other liver diseases, can affect attention, concentration, and working memory [ 19 , 150 , 151 , 152 ]. In addition, NAFLD patients more frequently suffer from neuropsychiatric symptoms such as anxiety and depression that are also associated with impaired memory, attention, and executive function [ 153 , 154 , 155 ].…”

Cancer Patients Have an Increased Incidence of Dementia: A Retrospective Cohort Study of 185,736 Outpatients in Germany

“…In conclusion, our data from a large German cohort of cancer-patients suggest a positive association between cancer and the development of dementia. Similarly to previous studies (see above), our study was subject to several limitations that were due to the study design and either could not be avoided at all or could not effectively be avoided in studies based on database analyses, as recently described [ 34 ]. First, the ICD-10 coding system was used, which might have led to misclassification and undercoding of certain diagnoses.…”

Leberspezifische Diagnostik bei der nichtalkoholischen Fettlebererkrankung (NAFLD) – wann kann die Leberbiopsie ersetzt werden?

“…Die Inzidenzraten von koronaren Herzerkrankungen, Myokardinfarkten und Vorhofflimmern sind bei Patienten mit NAFLD erhöht [10]. Aber auch weitere Komorbiditäten prägen das klinische Erscheinungsbild von Patienten mit NAFLD, und Analysen der letzten Jahre haben die NAFLD als unabhängigen Risikofaktor für das Auftreten einer Depression [11], von Tumorerkrankungen [12] und einer chronischen Niereninsuffizienz [13] für Patienten in Deutschland identifiziert. Diese organübergreifenden Einflüsse der NAFLD auf extrahepatische Erkrankungen werden im Zusammenhang mit einer in der Leber entstehenden metabolischen Entzündung erklärt [14].…”