Study of the sleep quality and psychological state of patients with hepatitis B liver cirrhosis

Xiao, Guoqing; Ye, Qing; Han, Tao; Yan, Junqing; Sun, Lixia; Wang, Fengmei

doi:10.1111/hepr.12981

Cited by 20 publications

(18 citation statements)

References 33 publications

(72 reference statements)

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“…showed a correlation between NCT-A results and PSQI scores in patients with cirrhosis induced by hepatitis B. [ 24 ] Similarly, we found that cirrhotic patients with MHE had worse EncephalApp results, considered as one of the independent predictors for poor sleep quality in these patients. The correlation may be attributed to poor sleep quality of MHE being associated with the specific neuropsychiatric impairments that can be exactly evaluated by EncephalApp.…”

Section: Discussionsupporting

confidence: 55%

EncephalApp Stroop App predicts poor sleep quality in patients with minimal hepatic encephalopathy due to hepatitis B-induced liver cirrhosis

Luo¹,

Yu²,

Hu³

et al. 2020

Saudi J Gastroenterol

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Background/Aim: A novel computerised Stroop test- EncephalApp Stroop App (EncephalApp) has good diagnostic validity for minimal hepatic encephalopathy (MHE) in cirrhotic patients. The Stroop test is correlated with sleep disturbances which are common, and severely affects health-related quality of life in cirrhotic patients with MHE. We evaluated the relationship between sleep quality and EncephalApp results in patients with MHE due to hepatitis B-induced liver cirrhosis. Patients and Methods: We enrolled 180 adult patients with hepatitis B-induced cirrhosis. All patients were tested using the psychometric hepatic encephalopathy score (PHES) and EncephalApp. We analysed the diagnostic validity of EncephalApp for MHE using PHES as the gold standard for reference. The sleep quality of included patients was evaluated using the Pittsburgh Sleep Quality Index (PSQI). The predictive factors for poor sleep quality were analysed using backwards conditional stepwise logistic regression analysis. Results: Ninety-eight patients (54.4%) were diagnosed with MHE by PHES. Receiver operating characteristic (ROC) curve analysis showed that the threshold value of EncephalApp for MHE diagnosis was 225.60 s. EncephalApp showed 85.2% sensitivity and 77.3% specificity for diagnosing MHE; the area under the ROC curve was 0.864. PSQI scores of cirrhotic patients with MHE were significantly lower than those without MHE ( P < 0.05). Child Turcotte Pugh grades (Odds ratio [OR] = 2.11 [1.55–2.85], P < 0.01) and the total Off-time plus On-time of EncephalApp (OR = 4.14 [1.95–6.29], P < 0.01) were independent predictors of poor sleep quality in MHE patients. Conclusions: The total Off-time plus On-time of EncephalApp predicts poor sleep quality in patients with MHE due to hepatitis B-induced cirrhosis.

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Section: Discussionsupporting

confidence: 55%

EncephalApp Stroop App predicts poor sleep quality in patients with minimal hepatic encephalopathy due to hepatitis B-induced liver cirrhosis

Luo¹,

Yu²,

Hu³

et al. 2020

Saudi J Gastroenterol

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“…A total of 39 studies assessing symptom prevalence were included (see Supplementary Material). 20–58 The majority reported data from North America (16) and Europe (14), although Asia (8) and Africa (1) were also covered. Most were cross-sectional studies conducted while patients were outpatients or stable after hospitalization.…”

Section: Symptom Prevalence Of Patients With End-stage Liver Diseasementioning

confidence: 99%

Symptom prevalence and quality of life of patients with end-stage liver disease: A systematic review and meta-analysis

et al. 2018

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Background:End-stage liver disease is a common cause of morbidity and mortality worldwide, yet little is known about its symptomatology and impact on health-related quality of life.Aim:To describe symptom prevalence and health-related quality of life of patients with end-stage liver disease to improve care.Design:Systematic review.Data sources:We searched eight electronic databases from January 1980 to June 2018 for studies investigating symptom prevalence or health-related quality of life of adult patients with end-stage liver disease. No language restrictions were applied. Meta-analyses were performed where appropriate.Results:We included 80 studies: 35 assessing symptom prevalence, 41 assessing health-related quality of life, and 4 both. The instruments assessing symptoms varied across studies. The most frequently reported symptoms were as follows: pain (prevalence range 30%–79%), breathlessness (20%–88%), muscle cramps (56%–68%), sleep disturbance (insomnia 26%–77%, daytime sleepiness 29.5%–71%), and psychological symptoms (depression 4.5%–64%, anxiety 14%–45%). Erectile dysfunction was prevalent (53%–93%) in men. The health-related quality of life of patients with end-stage liver disease was significantly impaired when compared to healthy controls or patients with chronic liver disease. Compared with compensated cirrhosis, decompensation led to significant worsening of both components of the 36-Item Short Form Survey although to a larger degree for the Physical Component Summary score (decrease from average 6.4 (95% confidence interval: 4.0–8.8); p < 0.001) than for the Mental Component Summary score (4.5 (95% confidence interval: 2.4–6.6); p < 0.001).Conclusion:The symptom prevalence of patients with end-stage liver disease resembled that of patients with other advanced conditions. Given the diversity of symptoms and significantly impaired health-related quality of life, multidisciplinary approach and timely intervention are crucial.

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“…The number of participants differs significantly between studies too. Xiao et al's study 14 has the highest number of participants followed by Stewart et al's study. 20 Interestingly, both studies demonstrate a significant association between depression and HE.…”

Section: Resultsmentioning

confidence: 91%

“…Table 1 highlights a marked discrepancy between the results. Some findings show a significant association between anxiety/depressive disorders and HE, 14,15,20,21 others strongly reject this relationship, 17,18 and another study demonstrates a partial association between specific aspects of each illness. 16 Two studies reveal increased BDI scores in HE, but this result is not compared with that from control groups.…”

Section: Resultsmentioning

confidence: 94%

The association between hepatic encephalopathy/minimal hepatic encephalopathy and depressive and anxiety disorders: a systematic review

Eftekar

2019

Australas Psychiatry

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Objectives: This review examined the currently available evidence of the association between liver encephalopathy and mood/anxiety disorders. Method: English-language studies using the keywords “hepatic encephalopathy,” “depression,” and “anxiety” were searched through PubMed, Medline, Cochrane Library, and PsycINFO databases. A total of 135 articles were considered for this review, of which 9 were qualitative and quantitative research papers regarding depression and anxiety in hepatic encephalopathy (HE). Results: There is a significant discrepancy between the research method of the studies and their outcomes. The number of studies suggesting a relationship between HE and mood/anxiety disorders is slightly higher than that of studies with opposite results; however, based on the current evidence, it is difficult to conclude a significant association between these two conditions. Conclusion: More longitudinal studies that include face-to-face psychiatric assessments are required to highlight any possible association between depressive/anxiety disorders and HE.

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Study of the sleep quality and psychological state of patients with hepatitis B liver cirrhosis

Cited by 20 publications

References 33 publications

EncephalApp Stroop App predicts poor sleep quality in patients with minimal hepatic encephalopathy due to hepatitis B-induced liver cirrhosis

EncephalApp Stroop App predicts poor sleep quality in patients with minimal hepatic encephalopathy due to hepatitis B-induced liver cirrhosis

Symptom prevalence and quality of life of patients with end-stage liver disease: A systematic review and meta-analysis

The association between hepatic encephalopathy/minimal hepatic encephalopathy and depressive and anxiety disorders: a systematic review

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