Depression and Insomnia Are Closely Associated with Thyroid Hormone Levels in Chronic Hepatitis B
Open accessAbstract
BACKGROUND Depression and insomnia in chronic hepatitis B (CHB) patients affect the quality of life, disease diagnosis, and mortality. CHB patients are more likely to have psychological disorders, but the underlying mechanisms have not been elucidated. This study investigated the incidence of depression in patients with CHB and sought to identify risk factors for depression and insomnia in these patients, focusing on changes in liver function and thyroid hormone levels. MATERIAL AND METHODS This cross-sectional cohort study used the Hamilton Depression Scale and Athens Insomnia Scale to assess the depressive and insomnia states, respectively, of 209 CHB patients. Liver function, thyroid hormone levels, hepatitis B surface antigen, hepatitis B e-antigen, and hepatitis B virus-deoxyribonucleic acid load were evaluated. Liver cirrhosis was assessed by imaging (color Doppler ultrasound and computed tomography). A multivariate logistic regression model was used to analyze the correlation among various factors and depression and insomnia. RESULTS Subclinical and clinical depressive states were found in 23.9% and 5.3% and subclinical and clinical insomnia in 11% and 35.4% of patients, respectively. Depression and insomnia severity were significantly correlated with low FT3 (<3.5 mol/L). The odds ratios of low FT3 for subclinical and clinical depression and clinical insomnia were 3.07 (95% confidence interval (CI), 1.248-7.568), 7.85 (95% CI, 1.839-33.547), and 3.91 (95% CI, 1.417-10.789), respectively. CONCLUSIONS CHB patients are prone to depression and insomnia. FT3 reduction may be a risk factor for depression and insomnia. In clinical settings, more attention needs to be paid to the mental state of patients with FT3 reduction.
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The prevalence of depression in patients with hepatitis B virus has been examined, though limited data on rates of anxiety are available.
“The prevalence of DEP in patients with HBV has been examined, [12,17,23,28,31,32] though limited data on rates of ANX are available.[17,28]”
From Prevalence of depression and anxiety symptoms by liver disease etiology (2023) · cites this paper as [23]
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Prevalence of depression and anxiety symptoms by liver disease etiology
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- Authors
- Huang, X., Zhang, H., Qu, C., Liu, Y., Bian, C., & Xu, Y.
- Affiliations
- Affiliated Hospital of Qingdao University (CN)
- Corresponding author
- Bian, Cheng
- Xu, Yonghong
- ORCID
- Venue
- Medical Science Monitor
- Published
- 2019-04-11
- Volume
- 25
- Pages
- 2672-2678
- ISSN
- 1234-1010 (ISSN-L)
- 1643-3750
- PMC
- PMC6475122
- OpenAlex
- W2939886305
- Cited by
- 19
- References
- 30
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 2 · 2023: 4 · 2022: 2 · 2021: 2 · 2020: 3
- FWCI
- 1.42
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Medical Science Monitor (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Qingdao University
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Epidemiology › Hepatitis B Virus Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- chronic hepatitis B, depression, insomnia, thyroid hormones, free triiodothyronine, subthreshold depression, liver cirrhosis, liver function, risk factors
- MeSH terms
- Adult, Depression, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Thyroid Hormones, Multivariate Analysis, Logistic Models, Hepatitis B, Chronic
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