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Associations of depression, anxiety and antidepressants with histological severity of nonalcoholic fatty liver disease.

Publication ,  Journal Article
Youssef, NA; Abdelmalek, MF; Binks, M; Guy, CD; Omenetti, A; Smith, AD; Diehl, AME; Suzuki, A
Published in: Liver Int
August 2013

BACKGROUND: Depression and anxiety are common in patients with nonalcoholic fatty liver disease (NAFLD). However, their associations with histological severity of NAFLD are unknown. AIM: This study examined the association(s) of depression, anxiety and antidepressant pharmacotherapy with severity of histological features in patients with NAFLD. METHODS: We analysed 567 patients with biopsy-proven NAFLD enrolled in the Duke NAFLD Clinical Database. Depressive and anxiety symptoms were assessed using the Hospital Anxiety & Depression Scale (HADS). The associations of depression and anxiety with severity of histological features of NAFLD were analysed using multiple logistic (or ordinal logistic) regression models with and without adjusting for confounding factors. RESULT: Subclinical and clinical depression was noted in 53% and 14% of patients respectively. Subclinical and clinical anxiety was noted in 45% and 25% of patients respectively. After adjusting for confounders, depression was significantly associated with more severe hepatocyte ballooning in a dose-dependent manner (likelihood ratio test, P = 0.0201); adjusted cumulative odds ratio (COR) of subclinical and clinical depression for having a higher grade of hepatocyte ballooning were 2.1 [95% CI, 1.0, 4.4] and 3.6 [95% CI, 1.4, 8.8]. CONCLUSIONS: In patients with NAFLD, depression was associated with more severe hepatocyte ballooning. Further investigation exploring pathobiological mechanisms underlying the observed associations and potential effects of antidepressant pharmacotherapy on NAFLD liver histology is warranted.

Duke Scholars

Published In

Liver Int

DOI

EISSN

1478-3231

Publication Date

August 2013

Volume

33

Issue

7

Start / End Page

1062 / 1070

Location

United States

Related Subject Headings

  • Surveys and Questionnaires
  • Odds Ratio
  • North Carolina
  • Non-alcoholic Fatty Liver Disease
  • Middle Aged
  • Male
  • Logistic Models
  • Likelihood Functions
  • Humans
  • Gastroenterology & Hepatology
 

Citation

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Youssef, N. A., Abdelmalek, M. F., Binks, M., Guy, C. D., Omenetti, A., Smith, A. D., … Suzuki, A. (2013). Associations of depression, anxiety and antidepressants with histological severity of nonalcoholic fatty liver disease. Liver Int, 33(7), 1062–1070. https://doi.org/10.1111/liv.12165
Youssef, Nagy A., Manal F. Abdelmalek, Martin Binks, Cynthia D. Guy, Alessia Omenetti, Alastair D. Smith, Anna Mae E. Diehl, and Ayako Suzuki. “Associations of depression, anxiety and antidepressants with histological severity of nonalcoholic fatty liver disease.Liver Int 33, no. 7 (August 2013): 1062–70. https://doi.org/10.1111/liv.12165.
Youssef NA, Abdelmalek MF, Binks M, Guy CD, Omenetti A, Smith AD, et al. Associations of depression, anxiety and antidepressants with histological severity of nonalcoholic fatty liver disease. Liver Int. 2013 Aug;33(7):1062–70.
Youssef, Nagy A., et al. “Associations of depression, anxiety and antidepressants with histological severity of nonalcoholic fatty liver disease.Liver Int, vol. 33, no. 7, Aug. 2013, pp. 1062–70. Pubmed, doi:10.1111/liv.12165.
Youssef NA, Abdelmalek MF, Binks M, Guy CD, Omenetti A, Smith AD, Diehl AME, Suzuki A. Associations of depression, anxiety and antidepressants with histological severity of nonalcoholic fatty liver disease. Liver Int. 2013 Aug;33(7):1062–1070.
Journal cover image

Published In

Liver Int

DOI

EISSN

1478-3231

Publication Date

August 2013

Volume

33

Issue

7

Start / End Page

1062 / 1070

Location

United States

Related Subject Headings

  • Surveys and Questionnaires
  • Odds Ratio
  • North Carolina
  • Non-alcoholic Fatty Liver Disease
  • Middle Aged
  • Male
  • Logistic Models
  • Likelihood Functions
  • Humans
  • Gastroenterology & Hepatology