Incidence of Depression and Anxiety in a Cohort of Adolescents With Nonalcoholic Fatty Liver Disease

Noon, Sheila L.; D’Annibale, Danielle A.; Schwimmer, M; Shiels, Jacqueline; Arin, Jennifer; Durelle, Janis; Newton, Kimberly P.; Goyal, Nidhi; Schwimmer, Jeffrey B.

doi:10.1097/mpg.0000000000003024

Cited by 12 publications

(10 citation statements)

References 23 publications

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“…In a longitudinal cohort study of 160 adolescents with biopsy-proven NAFLD, Noon et al demonstrated that the mental health burden adolescents with NAFLD face is substantial. 33 Over a 4 year average following diagnosis with NAFLD, 1 in 6 adolescents with NAFLD developed clinically relevant depression. Notably, adolescents with NAFLD whose liver chemistry worsened over time were more likely to develop depression.…”

Section: Depression and Anxietymentioning

confidence: 99%

Recent advances in the epidemiology of nonalcoholic fatty liver disease in children

2021

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Children with obesity are at risk for numerous health problems, including nonalcoholic fatty liver disease (NAFLD). This review focuses on progress made in the epidemiology of NAFLD in children for the years 2015-2020. The estimated prevalence of NAFLD in children with obesity is 26%. The incidence of NAFLD in children has risen rapidly over the past decade. An understanding of the reasons for this rise is incomplete, but over the past 5 years, many studies have provided additional insight into the complexity of risk factors, diagnostic approaches, and associated comorbidities. Risk factors for NAFLD are wide-ranging, including perinatal factors involving both the mother and newborn, as well as environmental toxin exposure.Progress made in the noninvasive assessment will be critical to improving issues related to variability in approach to screening and diagnosis of NAFLD in children.The list of serious comorbidities observed in children with NAFLD continues to grow.Notably, for many of these conditions, such as diabetes and depression, the rates observed have exceeded the rates reported in children with obesity without NAFLD.Recent advancements reviewed show an increased awareness of this problem, while also calling attention to the need for additional research to guide successful efforts at prevention and treatment.

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Section: Depression and Anxietymentioning

confidence: 99%

Recent advances in the epidemiology of nonalcoholic fatty liver disease in children

2021

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“…In the cohort by Cho et al, obese people with greater severity of depression exhibited an increased risk of having NASH with greater degrees of fibrosis when compared to obese people having lesser to no depression (aH R = 3.55, 95% CI: 1.38–9.13, p < 0.005) 14 . Similarly, in the second longitudinal study, adolescents who developed depression reported worse outcomes based on alanine transferase liver enzyme serology (indicator of liver injury) when compared with those who did not develop depression (i.e., improved 21%, stable 36%, worse 43% versus improved 42%, stable 35%, worse 23%; p < 0.01, respectively) 15 …”

Section: Association Of Nafld With Psychiatric Disordersmentioning

confidence: 81%

“…Another longitudinal study that followed adolescents ( n = 160) with NAFLD for a mean duration of 3.8 years reported a steady increase in the incidence of depression among participants over time from baseline (i.e., 8.1% had depression initially) 15 . During the follow-up period, an additional 9.5% (95% CI = 4.7%–14.3%) of the adolescents with NAFLD developed depression.…”

Section: Association Of Nafld With Psychiatric Disordersmentioning

confidence: 99%

“…During the follow-up period, an additional 9.5% (95% CI = 4.7%–14.3%) of the adolescents with NAFLD developed depression. However, the study by Noon et al was limited due to the lack of control group (i.e., adolescents without NAFLD) and relatively small number of participants 15 . Further information regarding important diagnostic definitions, patient characteristics, and relevant findings of these two cohorts is delineated in Table 1.…”

Section: Association Of Nafld With Psychiatric Disordersmentioning

confidence: 99%

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The bidirectional association of nonalcoholic fatty liver disease with depression, bipolar disorder, and schizophrenia

et al. 2022

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Nonalcoholic fatty liver disease (NAFLD) is a complex metabolic-inflammatory disease associated with poor outcomes and decreased quality of life. NAFLD is overrepresented in patients with psychiatric disorders like depression, bipolar disorder, and schizophrenia; however, a comprehensive review on NAFLD and psychiatric disorders remains to be delineated. This review endeavors to investigate the association of NAFLD with psychiatric disorders, including shared pathogenesis and future clinical derivatives. Extant literature suggests that patients with psychiatric disorders (in particular, mood disorders) are more susceptible to the development of NAFLD due to multiple reasons, including but not limited to hypothalamic–pituitary–adrenal axis dysregulation, metabolic syndrome, and chronic perceived stress. Moreover, the clinical manifestations of mood disorders (e.g., anhedonia, psychomotor retardation, lifestyle modification, etc.), and potentially long-term treatment with weight-gaining agents, differentially affect these patients, making them more prone to NAFLD. Considering the increased morbidity associated with both mood disorders and NAFLD, our review recommends regular screenings for NAFLD in select patients with mood disorders exhibiting signs of increased risk (i.e., obesity, metabolic syndrome, diabetes, or family history of NAFLD) for better diagnosis and holistic care of both potentially interrelated conditions.

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“…It has been reported that high bilirubin level was associated with depression [ 38 ]. Elevated ALT was found in adolescents with NAFLD who developed depression [ 39 ] and it was also a significant independent predictor for the occurrence of minor and major depression in adults [ 40 ]. Moreover, depression would escalate the histological changes in reverse, probably through the monoamine oxidase-A enzyme pathway [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

The association between serum albumin and depression in chronic liver disease may differ by liver histology

Cao

Qiu

et al. 2022

BMC Psychiatry

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Background There are conflicting results regarding the association between chronic liver disease (CLD) and depression and the underlying biological mechanisms are lack of investigation. To address the impact of depression and its effects on the management of CLD, its biological marker is critical to be identified. The present study explored the association between serum albumin and depression in CLD patients and whether the association varied in different liver histological stages. Methods Based on the United States National Health and Nutrition Examination Survey 2017–2018, the data of serum albumin and depressive symptoms from 627 participants with CLD were used. Depression symptoms were assessed with the nine-item Patient Health Questionnaire (PHQ-9). We used multivariate linear regression to evaluate the association between serum albumin and PHQ-9 scores. Stratified analysis was performed according to the liver histology examined by vibration controlled transient elastography. Results Serum albumin level was inversely associated with PHQ-9 scores in the multivariate regression model after adjusting for mainly potential confounders (β = − 1.113, 95% CI: − 2.065 to − 0.162, P = 0.0221). In the subgroup analysis stratified by gender, controlled attenuation parameter (CAP) and liver stiffness measurement (LSM), the inverse association remained significant in female (β = − 2.002, 95% CI: − 3.515 to − 0.489, P = 0.0100), patients with CAP < 274 dB/m (β = − 2.215, 95% CI: − 3.621 to − 0.808, P = 0.0023) and patients with LSM ≥8.2 kPa (β = − 4.074, 95% CI: − 6.237 to − 1.911, P = 0.0003). Moreover, the association was much stronger when the serum albumin was higher than 3.4 g/dL among patients with LSM ≥8.2 kPa (β = − 4.835, 95% CI: − 7.137 to − 2.533, P < 0.0001). Conclusion Our study revealed an inverse association between serum albumin and depression in CLD patients and this association differed according to liver histological changes. Serum albumin could be a warning marker for depressive symptoms in CLD patients. It is essential for taking corresponding intervention strategies.

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Incidence of Depression and Anxiety in a Cohort of Adolescents With Nonalcoholic Fatty Liver Disease

Cited by 12 publications

References 23 publications

Recent advances in the epidemiology of nonalcoholic fatty liver disease in children

Recent advances in the epidemiology of nonalcoholic fatty liver disease in children

The bidirectional association of nonalcoholic fatty liver disease with depression, bipolar disorder, and schizophrenia

The association between serum albumin and depression in chronic liver disease may differ by liver histology

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