Prevalence and associated factors of anxiety and depression in liver cirrhosis at outpatient clinic

Authors

  • Naphat Sirinimnualkul Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • Piyawat Komolmit Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • Teerayuth Rungnirundorn Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

Keywords:

Prevalence, factors, anxiety, depression, cirrhosis

Abstract

Background: Liver cirrhosis is one of the chronic medical conditions which frequently leads to psychiatric comorbidities including depression and anxiety disorder.

Objective: The aim of this study was to evaluate the prevalence and associated factors of anxiety and depression in patients with liver cirrhosis in outpatient clinic.

Methods: Patients with liver cirrhosis aged from 18 years and above, excluded active liver malignancy, were recruited from liver clinic at outpatient of department of medicine. Anxiety and depression were identified using Thai Hospital Anxiety and Depression Scale (THAI-HADS). Descriptive statistic was applied to estimate prevalence of anxiety and depression and factors associated with each condition was analyzed by logistic regression analysis.

Results: Of 108 subjects, 53.7% were female with mean age approximately 60 years. Totally, 55.5% of the subjects had compensated cirrhosis and the most common etiology was hepatitis C virus (33.3%). The prevalence of anxiety was 10.2% and depression was 11.1%. The predictive factors for anxiety were being male (OR = 11.3, P = 0.01), having compensated liver cirrhosis (OR = 5.9, P = 0.045), having poor social support (OR = 3.9, P = 0.047) and having three or more of physical symptoms (OR = 9.6, P = 0.007). With regard to depression, the predictors were being male (OR = 6.4, P = 0.024), having poor social support (OR = 5.6, P = 0.025) and having three or more of physical symptoms (OR = 5.2, P = 0.026).

Conclusion: The prevalence of anxiety and depression in patients with liver cirrhosis at outpatient clinic was approximately 10.0%. The predictive factors for those psychiatric conditions were being male, having poor social support and having numbers of physical symptoms. In addition, having compensated liver cirrhosis was also a risk factor for anxiety.

Downloads

Download data is not yet available.

References

D'Amico G, Morabito A, D'Amico M, Pasta L, Malizia G, Rebora P, et al. New concepts on the clinical course and stratification of compensated and decompensated cirrhosis. Hepatol Int 2018;12 Suppl 1:34-43. https://doi.org/10.1007/s12072-017-9808-z

Poovorawan K, Treeprasertsuk S, Thepsuthammarat K, Wilairatana P, Kitsahawong B, Phaosawasdi K. The burden of cirrhosis and impact of universal coverage public health care system in thailand: Nationwide study. Ann Hepatol 2015;14:862-8.

https://doi.org/10.5604/16652681.1171773

Forner A, Llovet JM, Bruix J. Hepatocellular carcinoma. Lancet 2012;379:1245-55. https://doi.org/10.1016/S0140-6736(11)61347-0

Wong CCY, Warmoth K, Ivy S, Cheung B, Lu Q. Relation of social constraints on disclosure to adjustment among chinese american cancer survivors: A multiprocesses approach. Psychooncology 2018;27:977-82. https://doi.org/10.1002/pon.4604

Kagee A, Roomaney R, Knoll N. Psychosocial predictors of distress and depression among south african breast cancer patients. Psychooncology 2018;27:908-14. https://doi.org/10.1002/pon.4589

Henry A, Tourbah A, Camus G, Deschamps R, Mailhan L, Castex C, et al. Anxiety and depression in patients with multiple sclerosis: The mediating effects of perceived social support. Mult Scler Relat Disord 2019;27:46-51. https://doi.org/10.1016/j.msard.2018.09.039

Zhang AZ, Wang QC, Huang KM, Huang JG, Zhou CH, Sun FQ, et al. Prevalence of depression and anxiety in patients with chronic digestive system diseases: A multicenter epidemiological study. World J Gastroenterol 2016;22:9437-44.

https://doi.org/10.3748/wjg.v22.i42.9437

Nilchaikovit T, Lotrakul M, Phisansuthideth U. Development of Thai version of hospital anxiety and depression scale in cancer patients. J Psychiatr Assoc Thai 1996;41:18-30.

Saunders JB, Aasland OG, Amundsen A, Grant M. Alcohol consumption and related problems among primary health care patients: WHO collaborative project on early detection of persons with harmful alcohol consumption-i. Addiction 1993;88:349-62.

https://doi.org/10.1111/j.1360-0443.1993.tb00822.x

Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the alcohol use disorders identification test (audit): Who collaborative project on early detection of persons with harmful alcohol consumption-ii. Addiction 1993;88:791-804.

https://doi.org/10.1111/j.1360-0443.1993.tb02093.x

Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG.. AUDIT: The Alcohol use disorders identification test: Guidelines for use in primary health care. 2nd ed. Geneva: World Health Organization;2001.

Schaefer C, Coyne JC, Lazarus RS. The health-related functions of social support. J Behav Med 1981;4:381-406.

https://doi.org/10.1007/BF00846149

Lueboonthavatchai P. Prevalence and psychosocial factors of anxiety and depression in breast cancer patients. J Med Assoc Thai 2007;90:2164-74.

Buganza -Torio E, Mitchell N, Abraldes JG, Thomas L, Ma M, Bailey RJ, et al. Depression in cirrhosis-a prospective evaluation of the prevalence, predictors and development of a screening nomogram. Aliment Pharmacol Ther 2019;49:194-201.

https://doi.org/10.1111/apt.15068

Popović DD, Ćulafić DM, Tepavčević DB, Kovačević NV, Špuran MM, Djuranović SP, et al. Assessment of depression and anxiety in patients with chronic liver disease. Vojnosanit Pregl 2015;72:414-20. https://doi.org/10.2298/VSP130904007P

Perng CL, Shen CC, Hu LY, Yeh CM, Chen MH, Tsai CF, et al. Risk of depressive disorder following non-alcoholic cirrhosis: A nationwide populationbased study. PLoS One 2014;9:e88721. https://doi.org/10.1371/journal.pone.0088721

Vlassoff C. Gender differences in determinants and consequences of health and illness. J Health Popul Nutr 2007;25:47-61.

Valery PC, Clark PJ, McPhail SM, Rahman T, Hayward K, Martin J, et al. Exploratory study into the unmet supportive needs of people diagnosed with cirrhosis in queensland, australia. Intern Med J 2017;47: 429-35. https://doi.org/10.1111/imj.13380

Valery PC, Powell E, Moses N, Volk ML, McPhail SM, Clark PJ, et al. Systematic review: Unmet supportive care needs in people diagnosed with chronic liver disease. BMJ Open. 2015;5:e007451. https://doi.org/10.1136/bmjopen-2014-007451

Xu H, Zhou Y, Ko F, Ping J, Zhang J, Zhao C, et al. Female gender and gastrointestinal symptoms, not brain-derived neurotrophic factor, are associated with depression and anxiety in cirrhosis. Hepatol Res 2017;47:E64-e73. https://doi.org/10.1111/hepr.12723

Fritz E, Hammer J. Gastrointestinal symptoms in patients with liver cirrhosis are linked to impaired quality of life and psychological distress. Eur J Gastroenterol Hepatol 2009;21:460-5. https://doi.org/10.1097/MEG.0b013e328318ed19

Ko FY, Yang AC, Tsai SJ, Zhou Y, Xu LM. Physiologic and laboratory correlates of depression, anxiety, and poor sleep in liver cirrhosis. BMC Gastroenterol 2013;13:18. https://doi.org/10.1186/1471-230X-13-18

Kittirattanapaiboon P, Tantirangsee N, Chutha W, Tantiaree A, Kwansanit P, Assanangkornchai S. et al. Prevalence of mental disorders and mental health problems: Results from Thai national mental health survey 2013. J Mental Health of Thailand 2017;25:1-19.

Downloads

Published

2023-07-17

How to Cite

1.
Sirinimnualkul N, Komolmit P, Rungnirundorn T. Prevalence and associated factors of anxiety and depression in liver cirrhosis at outpatient clinic. Chula Med J [Internet]. 2023 Jul. 17 [cited 2024 Nov. 22];66(2). Available from: https://he05.tci-thaijo.org/index.php/CMJ/article/view/77