The DOI matches its Crossref record; 42 of the 42 references it cites were found in a registry or an index.
Associations of depression, anxiety and antidepressants with histological severity of nonalcoholic fatty liver disease
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.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“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 the citing paper
“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 the citing paper
“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 the citing paper
“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 the citing paper
“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]
Citations
Cites
The Hospital Anxiety and Depression Scale
Zigmond, A. S., & Snaith, R. P. (1983) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1983.tb09716.x · Cited by 47,139
Design and validation of a histological scoring system for nonalcoholic fatty liver disease†
Kleiner, D. E., Brunt, E. M., Van Natta, M., Behling, C., Contos, M. J., Cummings, O. W., Ferrell, L. D., Liu, Y., Torbenson, M. S., Unalp‐Arida, A., et al. (2005) · Hepatology · doi:10.1002/hep.20701 · Cited by 10,791
Prevalence of Hepatic Steatosis in An Urban Population in the United States: Impact of Ethnicity
Browning, J. D., Szczepaniak, L. S., Dobbins, R., Nuremberg, P., Horton, J. D., Cohen, J. C., Grundy, S. M., & Hobbs, H. H. (2004) · Hepatology · doi:10.1002/hep.20466 · Cited by 3,664
The Hospital Anxiety And Depression Scale.
(2003) · Health and Quality of Life Outcomes · doi:10.1186/1477-7525-1-29 · Cited by 2,391
Depression and poor glycemic control: a meta-analytic review of the literature.
Lustman, P. J., Anderson, R. J., Freedland, K. E., de Groot, M., Carney, R. M., & Clouse, R. E. (2000) · Diabetes Care · doi:10.2337/diacare.23.7.934 · Cited by 1,854
Fatty liver hepatitis (steatohepatitis) and obesity: an autopsy study with analysis of risk factors.
Wanless, I. R., & Lentz, J. S. (1990) · Hepatology · doi:10.1002/hep.1840120505 · Cited by 1,191
Nonalcoholic fatty liver disease
Clark, J. M., Brancati, F. L., & Diehl, A. M. (2002) · Gastroenterology · doi:10.1053/gast.2002.33573 · Cited by 929
Self-citationMaes, M., Song, C., Lin, A., De Jongh, R., Van Gastel, A., Kenis, G., Bosmans, E., De Meester, I., Benoy, I., Neels, H., et al. (1998) · Cytokine · doi:10.1006/cyto.1997.0290 · Cited by 772
Relationship of depression to diabetes types 1 and 2: epidemiology, biology, and treatment
Musselman, D. L., Betan, E. J., Larsen, H., & Phillips, L. S. (2003) · Biological Psychiatry · doi:10.1016/s0006-3223(03)00569-9 · Cited by 687
Meyer, J. H., Ginovart, N., Boovariwala, A., Sagrati, S., Hussey, D., Garcia, A., Young, T., Praschak-Rieder, N., Wilson, A. A., & Houle, S. (2006) · Archives of General Psychiatry · doi:10.1001/archpsyc.63.11.1209 · Cited by 585
Lustman, P. J., Griffith, L. S., Freedland, K. E., Kissel, S. S., & Clouse, R. E. (1998) · Annals of Internal Medicine · doi:10.7326/0003-4819-129-8-199810150-00005 · Cited by 562
Penninx, B. W. J. H., Kritchevsky, S. B., Yaffe, K. S., Newman, A. B., Simonsick, E. M., Rubin, S. M., Ferrucci, L., Harris, T. B., & Pahor, M. (2003) · Biological Psychiatry · doi:10.1016/s0006-3223(02)01811-5 · Cited by 530
Prevalence of chronic liver disease in the general population of northern Italy: The dionysos study
Bellentani, S., Tiribelli, C., Saccoccio, G., Sodde, M., Fratti, N., Martin, C. D., & Christianini, G. (1994) · Hepatology · doi:10.1002/hep.1840200611 · Cited by 515
Survival, liver failure, and hepatocellular carcinoma in obesity-related cryptogenic cirrhosis
Ratziu, V., Bonyhay, L., Martino, V. D., Charlotte, F., Cavallaro, L. G., Sayegh-Tainturier, M.-H., Giral, P., Grimaldi, A., Opolon, P., & Poynard, T. (2002) · Hepatology · doi:10.1053/jhep.2002.33324 · Cited by 465
Long–Term Outcomes of Cirrhosis in Nonalcoholic Steatohepatitis Compared With Hepatitis C
Hui, J. M., Kench, J. G., Chitturi, S., Sud, A., Farrell, G. C., Byth, K., Hall, P. D. L. Μ., Khan, M., & George, J. (2003) · Hepatology · doi:10.1053/jhep.2003.50320 · Cited by 436
Effects of Nortriptyline on Depression and Glycemic Control in Diabetes
Lustman, P. J., Griffith, L. S., Clouse, R. E., Freedland, K. E., Eisen, S. A., Rubin, E. H., Carney, R. M., & McGill, J. B. (1997) · Psychosomatic Medicine · doi:10.1097/00006842-199705000-00007 · Cited by 405
A brain-liver circuit regulates glucose homeostasis
Pocai, A., Obici, S., Schwartz, G. J., & Rossetti, L. (2005) · Cell Metabolism · doi:10.1016/j.cmet.2004.11.001 · Cited by 392
Hospital Anxiety and Depression Scale (HADS): validation in a Greek general hospital sample
Michopoulos, I., Douzenis, A., Kalkavoura, C., Christodoulou, C., Michalopoulou, P., Kalemi, G., Fineti, K., Patapis, P., Protopapas, K., & Lykouras, L. (2008) · Annals of General Psychiatry · doi:10.1186/1744-859x-7-4 · Cited by 389
Anxiety and Poor Glycemic Control: A Meta-Analytic Review of the Literature
Anderson, R. J., Grigsby, A. B., Freedland, K. E., De Groot, M., McGill, J. B., Clouse, R. E., & Lustman, P. J. (2002) · The International Journal of Psychiatry in Medicine · doi:10.2190/klgd-4h8d-4ryl-twq8 · Cited by 328
Pathways linking depression, adiposity, and inflammatory markers in healthy young adults
Miller, G. E., Freedland, K. E., Carney, R. M., Stetler, C., & Banks, W. A. (2003) · Brain Behavior and Immunity · doi:10.1016/s0889-1591(03)00057-6 · Cited by 252
Okamura, F., Tashiro, A., Utumi, A., Imai, T., Suchi, T., Tamura, D., Sato, Y., Suzuki, S., & Hongo, M. (2000) · Metabolism · doi:10.1053/meta.2000.9515 · Cited by 242
Serum cytokine and soluble cytokine receptor levels in patients with non‐alcoholic steatohepatitis
Abiru, S., Migita, K., Maeda, Y., Daikoku, M., Ito, M., Ohata, K., Nagaoka, S., Matsumoto, T., Takii, Y., Kusumoto, K., et al. (2005) · Liver International · doi:10.1111/j.1478-3231.2005.01191.x · Cited by 209
Insulin resistance after oral glucose tolerance testing in patients with major depression
Winokur, A., Maislin, G., Phillips, J. L., & Amsterdam, J. D. (1988) · American Journal of Psychiatry · doi:10.1176/ajp.145.3.325 · Cited by 203
Nocito, A., Dahm, F., Jochum, W., Jang, J. H., Georgiev, P., Bäder, M., Renner, E. L., & Clavien, P. (2007) · Gastroenterology · doi:10.1053/j.gastro.2007.05.019 · Cited by 175
Non‐alcoholic steatohepatitis in the Asia–Pacific region: Future shock?
Chitturi, S., Farrell, G. C., & George, J. (2004) · Journal of Gastroenterology and Hepatology · doi:10.1111/j.1440-1746.2003.03252.x · Cited by 150
Depression in patients with nonalcoholic fatty liver disease and chronic viral hepatitis B and C
Weinstein, A. A., Kallman Price, J., Stepanova, M., Poms, L. W., Fang, Y., Moon, J., Nader, F., & Younossi, Z. M. (2011) · Psychosomatics · doi:10.1016/j.psym.2010.12.019 · Cited by 147
Diabetes mellitus, obesity, and hepatic steatosis.
Youssef, W. I., & McCullough, A. J. (2002) · PubMed · Cited by 127
Depression, Anxiety, and Nonalcoholic Steatohepatitis
Elwing, J. E., Lustman, P. J., Wang, H. L., & Clouse, R. E. (2006) · Psychosomatic Medicine · doi:10.1097/01.psy.0000221276.17823.df · Cited by 127
Guevara, M., Baccaro, M. E., Gómez‐Ansón, B., Frisoni, G. B., Testa, C., Torre, A., Molinuevo, J. L., Rami, L., Pereira, G., Sotil, E. U., et al. (2010) · Journal of Hepatology · doi:10.1016/j.jhep.2010.12.008 · Cited by 103
Osawa, Y., Kanamori, H., Seki, E., Hoshi, M., Ohtaki, H., Yasuda, Y., Ito, H., Suetsugu, A., Nagaki, M., Moriwaki, H., et al. (2011) · Journal of Biological Chemistry · doi:10.1074/jbc.m111.235473 · Cited by 96
Citalopram reduces endotoxin-induced fatigue
Hannestad, J., DellaGioia, N., Ortiz, N., Pittman, B., & Bhagwagar, Z. (2011) · Brain, Behavior, and Immunity · doi:10.1016/j.bbi.2010.10.013 · Cited by 95
The Reduction of R1, a Novel Repressor Protein for Monoamine Oxidase A, in Major Depressive Disorder
Johnson, S., Stockmeier, C. A., Meyer, J. H., Austin, M. C., Albert, P. R., Wang, J., May, W. L., Rajkowska, G., Overholser, J. C., Jurjus, G., et al. (2011) · Neuropsychopharmacology · doi:10.1038/npp.2011.105 · Cited by 85
Depression-Related Hyperglycemia in Type 1 Diabetes: A Mediational Approach
Lustman, P. J., Clouse, R. E., Ciechanowski, P. S., Hirsch, I. B., & Freedland, K. E. (2005) · Psychosomatic Medicine · doi:10.1097/01.psy.0000155670.88919.ad · Cited by 80
Haub, S., Kanuri, G., Volynets, V., Brune, T., Bischoff, S. C., & Bergheim, I. (2009) · American Journal of Physiology-Gastrointestinal and Liver Physiology · doi:10.1152/ajpgi.00088.2009 · Cited by 80
Fatty Liver Disease NASH and Related Disorders
Hughes, R. D. (2006) · European Journal of Gastroenterology & Hepatology · doi:10.1097/00042737-200606000-00020 · Cited by 71
Koslow, S. H., Stokes, P. E., Mendels, J., Ramsey, A., & Casper, R. C. (1982) · Psychological Medicine · doi:10.1017/s0033291700043270 · Cited by 57
Serotonin produces monoamine oxidase-dependent oxidative stress in human heart valves
Silva, R. A. P., Miller, J. D., Chu, Y., & Heistad, D. D. (2009) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00570.2009 · Cited by 56
Paracrine modulation of cholangiocyte serotonin synthesis orchestrates biliary remodeling in adults
Omenetti, A., Yang, L., Gainetdinov, R. R., Guy, C. D., Choi, S. S., Chen, W., Caron, M. G., & Diehl, A. M. (2010) · American Journal of Physiology-Gastrointestinal and Liver Physiology · doi:10.1152/ajpgi.00368.2010 · Cited by 46
Self-citationImpact of stress on alcoholic liver injury; a histopathological study
Shin, F., Suzuki, J., Tanaka, Y., Iwahashi, S., & Nomura, T. (1989) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(89)90013-5 · Cited by 35
Hypothalamic serotonin–insulin signaling cross-talk and alterations in a type 2 diabetic model
Papazoglou, I., Berthou, F., Vicaire, N., Rouch, C., Markaki, E. M., Bailbé, D., Portha, B., Taouis, M., & Gerozissis, K. (2011) · Molecular and Cellular Endocrinology · doi:10.1016/j.mce.2011.12.007 · Cited by 33
Manjarrez‐Gutiérrez, G., Herrera, R., León, M., & Hernández‐R, J. (2006) · Diabetes Care · doi:10.2337/diacare.29.01.06.dc05-1177 · Cited by 31
Manjarrez‐Gutiérrez, G. (2006) · Diabetes Care · doi:10.2337/diacare.29.1.73 · Cited by 21
Research works printed but not linked: 1
- Zigmond A, 1994, The HADS: Hospital Anxiety and Depression Scale, Windsor NFER Nelson
Cited by
Sorted by citations
Gender and menopause impact severity of fibrosis among patients with nonalcoholic steatohepatitis
Yang, J. D., Abdelmalek, M. F., Pang, H., Guy, C. D., Smith, A. D., Diehl, A. M., & Suzuki, A. (2014) · Hepatology · doi:10.1002/hep.26761 · Cited by 374
Self-citationMetabolic-associated Fatty Liver Disease (MAFLD): A Multi-systemic Disease Beyond the Liver
Kaya, E., & Yilmaz, Y. N. (2021) · Journal of Clinical and Translational Hepatology · doi:10.14218/jcth.2021.00178 · Cited by 241
Mullish, B. H., Kabir, M. S., Thursz, M. R., & Dhar, A. (2014) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.12925 · Cited by 144
Gut-derived systemic inflammation as a driver of depression in chronic liver disease
Kronsten, V. T., Tranah, T. H., Pariante, C. M., & Shawcross, D. L. (2021) · Journal of Hepatology · doi:10.1016/j.jhep.2021.11.008 · Cited by 137
Nonalcoholic Fatty Liver Disease Increases the Risk of Anxiety and Depression
Labenz, C., Huber, Y., Michel, M. S., Nagel, M., Galle, P. R., Kostev, K., & Schattenberg, J. M. (2020) · Hepatology Communications · doi:10.1002/hep4.1541 · Cited by 133
Metadata
- 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
- 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
- Locations
- Liver International (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Hepatology › 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review