Psychiatric morbidity in patients with alcoholic liver disease.

Ewusi-Mensah, I; Saunders, J B; Wodak, A D; Murray, Robin M.; Williams, Roger J.

doi:10.1136/bmj.287.6403.1417

Cited by 53 publications

(32 citation statements)

References 19 publications

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“…14,15,27 Other studies supported an association between HCV infection and depression. These studies found that patients with HCV infection were more likely to have psychiatric disorders; depression was the most frequent and clinically important diagnosis.…”

Section: Discussionmentioning

confidence: 88%

“…In early studies, the morbidity of mood and anxiety disorders was increased in patients with alcoholic cirrhosis compared with cirrhoses of other causes, using the Schedule for Affective Disorders and Schizophrenia and Research Diagnostic Criteria. 14,15 EwusiMensah et al 14 found that two thirds of in-patients with alcoholic liver disease had diagnosable psychiatric disorders compared with one third of a control group of patients with nonalcoholic liver disease. Another study found that three quarters of patients with alcoholic liver disease were affected by psychiatric disorders compared with only a quarter of nonalcoholic patients with liver disease.…”

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confidence: 99%

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Predictors of psychiatric disorders in liver transplantation candidates: Logistic regression models

Rocca

2003

Liver Transplantation

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This study has two goals. The first goal is to assess the prevalence of psychiatric disorders in orthotopic liver transplantation (OLT) candidates by means of standardized procedures because there has been little research concerning psychiatric problems of potential OLT candidates using standardized instruments. The second goal focuses on identifying predictors of these psychiatric disorders. One hundred sixty-five elective OLT candidates were assessed by our unit. O rthotopic liver transplantation (OLT) is an accepted standard of care for end-stage liver disease. The pre-OLT period is marked by declining physical function, adjustment-related anxiety and depression, and development of organic brain deficits. [1][2][3][4] Although several psychiatric follow-up studies are available for recipients and donors after OLT, [5][6][7] there are few studies concerning the psychiatric status of potential OLT candidates before OLT. There is heterogeneity in the results of these studies, and the findings need to be interpreted with caution because psychiatric diagnoses were determined by means of psychometric scales and only in few cases by a comprehensive clinical interview. 7,[8][9][10][11][12] Reported prevalence rates of psychiatric disorders among OLT candidates vary from 15% to 50%. [8][9][10][11][12] Another recent study describing psychological characteristics of a large sample of OLT candidates reports that more than half the patients presented at least mild levels of depression, and more than one third were affected by clinically elevated levels of anxiety, suggesting a greater incidence of depression and anxiety than previously reported. 13

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Section: Discussionmentioning

confidence: 88%

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confidence: 99%

Predictors of psychiatric disorders in liver transplantation candidates: Logistic regression models

Rocca

2003

Liver Transplantation

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“…4 Of 2 studies evaluating liver transplant candidates/recipients, the first (N = 73) identified 17% with symptoms of depression and 33% with symptoms of anxiety during pretransplantation assessment 5 ; whereas the second (N = 71) identified 66% with a current or past psychiatric illness, though none with psychotic spectrum disorders, such as schizophrenia and schizoaffective disorders. 6 A study evaluating heart transplant recipients indicated that "depression" (all forms) correlated positively with heart transplantation and with likelihood of posttransplant intervention needs. 7 In our review of the literature, no information on pre-existing mental illness rates was found for intestinal, lung, bone marrow, or pancreas transplants, although much was available about posttransplant mental health symptom development (regardless of transplant type).…”

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confidence: 99%

Posttransplantation Outcomes in Veterans With Serious Mental Illness

et al. 2015

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“…Patients were equally as likely to have developed depression before using alcohol excessively as they were afterwards. 43 Risk factors for alcohol recidivism after OLT have been found to include pre-operative depression and level of alcohol consumption, 44 with the evidence regarding the extent to which duration of pre-transplant abstinence contributes being contradictory.…”

Section: Hepatitis Bmentioning

confidence: 99%

Review article: depression and the use of antidepressants in patients with chronic liver disease or liver transplantation

Mullish

Kabir

Thursz

et al. 2014

Aliment Pharmacol Ther

108

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SummaryBackgroundThe scale of depression in patients with chronic liver disease (CLD) and those who have received orthotopic liver transplantation (OLT) is poorly characterised. Clinicians are uncertain of how best to manage depression within these patients.AimsTo review the literature evaluating both the prevalence and impact of depression in patients with CLD and post‐OLT, and to assess the safety and efficacy of antidepressant use within this context.MethodsA PubMed search using the phrases ‘chronic liver disease’, ‘cirrhosis’, ‘liver transplantation’, ‘depression’, ‘antidepressant’ and the names of specific causes of liver disease and individual antidepressants.ResultsOver 30% of cirrhotic patients have depressive features, and they experience worse clinical outcomes than nondepressed cirrhotic patients. CLD patients with chronic hepatitis C are particularly prone to depression, partly related to the use of interferon therapy. OLT patients with depression have higher mortality rates than nondepressed patients; appropriate antidepressant use reverses this effect. Selective serotonin reuptake inhibitors (SSRIs) and selective noradrenaline reuptake inhibitors (SNRIs) are effective and generally safe in both CLD and OLT patients.ConclusionsDepression is much more prevalent in CLD or OLT patients than is generally recognised, and it adversely affects clinical outcomes. The reasons for this relationship are complex and multifactorial. Antidepressants are effective in both CLD and post‐OLT, although lower doses or a reduced dosing frequency may be required to minimise side effects, e.g. exacerbation of hepatic encephalopathy. Further research is needed to establish optimal management of depression in these patients, including the potential role of nonpharmacological treatments.

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Psychiatric morbidity in patients with alcoholic liver disease.

Abstract: 1417composition in relation to fall in blood pressure with a note on measurement of angiotensin II during converting enzyme inhibition. Br HeartJ7

Cited by 53 publications

References 19 publications

Predictors of psychiatric disorders in liver transplantation candidates: Logistic regression models

Predictors of psychiatric disorders in liver transplantation candidates: Logistic regression models

Posttransplantation Outcomes in Veterans With Serious Mental Illness

Review article: depression and the use of antidepressants in patients with chronic liver disease or liver transplantation

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