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Cited by 182Liver Disease Diagnosis and TreatmentAlcohol Consumption and Health EffectsLiver Diseases and Immunity

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

Youssef, Nagy A., Abdelmalek, Manal F., Binks, Martin, Guy, Cynthia D., Omenetti, Alessia, Smith, Alastair D., Diehl, Anna Mae E., Suzuki, Ayako·2013·Liver International
DOI 10.1111/liv.12165
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Abstract

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.

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Crossref · 10.1111/liv.12165

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  • In a large population-based study of 567 patients with NAFLD, 25% reported moderate/severe anxiety symptoms.

    “Similar findings were also shown for ANX, as 25% of patients with NAFLD reported moderate/severe symptoms, while 45% reported subclinical ANX symptoms.[14]”

    From Prevalence of depression and anxiety symptoms by liver disease etiology (2023) · cites this paper as [14]

  • In a large population-based study of 567 patients with NAFLD, 53% reported subclinical/mild symptoms of depression.

    “In a large population-based study of 567 patients with NAFLD, [14] Youssef and colleagues showed that 14% of patients endorsed moderate to severe DEP on the Hospital Anxiety and Depression Scale (HADS), while 53% reported subclinical/mild symptoms of DEP.”

    From Prevalence of depression and anxiety symptoms by liver disease etiology (2023) · cites this paper as [14]

  • Youssef and colleagues reported that patients endorsing moderate/severe depression were 3.6 times more likely to present with more severe NAFLD compared with patients endorsing subclinical/no depression.

    “For example, Youssef and colleagues reported that patients endorsing moderate/severe DEP were 3.6 times more likely to present with more severe NAFLD compared with patients endorsing subclinical/no DEP.”

    From Prevalence of depression and anxiety symptoms by liver disease etiology (2023) · cites this paper as [14]

  • In a large population-based study of 567 patients with NAFLD, 14% endorsed moderate to severe depression on the Hospital Anxiety and Depression Scale.

    “In a large population-based study of 567 patients with NAFLD, [14] Youssef and colleagues showed that 14% of patients endorsed moderate to severe DEP on the Hospital Anxiety and Depression Scale (HADS), while 53% reported subclinical/mild symptoms of DEP.”

    From Prevalence of depression and anxiety symptoms by liver disease etiology (2023) · cites this paper as [14]

  • In a large population-based study of 567 patients with NAFLD, 45% reported subclinical anxiety symptoms.

    “Similar findings were also shown for ANX, as 25% of patients with NAFLD reported moderate/severe symptoms, while 45% reported subclinical ANX symptoms.[14]”

    From Prevalence of depression and anxiety symptoms by liver disease etiology (2023) · cites this paper as [14]

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Authors
Youssef, N. A., Abdelmalek, M. F., Binks, M., Guy, C. D., Omenetti, A., Smith, A. D., Diehl, A. M. E., & Suzuki, A.
Affiliations
  • Duke University (US)
  • Binks Behavioral Health PLLC Hillsborough NC USA
Corresponding author
Suzuki, Ayako
ORCID
Venue
Liver International
Publisher
Wiley
Published
2013-04-07
Volume
33
Issue
7
Pages
1062-1070
ISSN
  • 0106-9543 (ISSN-L)
  • 1478-3223
  • 1478-3231
DOI
10.1111/liv.12165
OpenAlex
W2038387606
Cited by
182
References
41
Citations by year
2026: 8 · 2025: 24 · 2024: 18 · 2023: 16 · 2022: 21 · 2021: 22 · 2020: 21 · 2019: 17 · 2018: 5 · 2017: 9 · 2016: 8 · 2015: 6 · 2014: 5 · 2013: 2
FWCI
5.11
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Liver International (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
  • Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
Keywords
non-alcoholic fatty liver disease, depression, anxiety, antidepressants, histological severity, hepatocyte ballooning, subthreshold depression, liver histopathology, psychiatric comorbidity
MeSH terms
Adult, Antidepressive Agents, Anxiety, Cross-Sectional Studies, Depression, Fatty Liver, Female, Humans, Male, Middle Aged, North Carolina, Surveys and Questionnaires, Likelihood Functions, Logistic Models, Odds Ratio, Non-alcoholic Fatty Liver Disease

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