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Depression, anxiety prevalent in young people with liver disease

Young people with chronic liver disease and who may have undergone liver transplant experience high levels of depression and anxiety, per published findings in Liver Transplantation.  

“Health care professionals should be aware of the high prevalence of mental health problems in young people with liver conditions and routinely inquire about young people’s psychosocial circumstances as both can impact on their illness and outcome,” Marianne Samyn, MD, FRCPCH, of King’s College Hospital, London, and study investigator said in a press release.

Young people with chronic illness have higher rates of mental illness vs. the general population; therefore, Samyn and colleagues sought to determine the prevalence of anxiety and depression in young people (aged 15 to 23) with chronic liver diseases. They aimed to identify factors that might cause distress and what role mental illness plays in determining their beliefs about their illness and treatment.

The researchers administered an electronic questionnaire routinely to patients attending an outpatient liver transition clinic in London. Some 182 patients participated and were divided based on liver etiology: autoimmune liver disease (sclerosing cholangitis; n = 69), had received a liver transplant (n = 51) or had other chronic liver conditions (n = 67).

Approximately 18% screened positive for anxiety or depression. This is significantly higher than the prevalence of common mental health problems in the general adolescent population, per the researchers.

Analysis showed a significant association between age and anxiety, with higher age linked to increased anxiety severity (P = .004). However, age was not associated with depression severity (P = .27).

Young people with other chronic liver diseases had higher levels of psychological distress compared with people who underwent LT or had autoimmune disease (P = .02). These patients also had a higher suicidal rate (P = .02).

Among all the patients, there were six frequently reported reasons for distress: fatigue, sleep difficulties, financial concerns, problems at work/school, worry and low self-esteem.

“Interestingly, the most common concerns young people with liver conditions report — such as lethargy, problems with sleeping and money, and work- or school-related issues — are very like their peers and can be addressed by a multidisciplinary team looking after them,” Samyn said in the release.

Depression and anxiety were not associated with perceived understanding of their illness or their beliefs as to how much treatment may assist them, the researchers wrote.

“The increased prevalence of mental health problems in [young people] and the intertwined nature of these with their physical health outcomes provide evidence that holistic care should be delivered as standard for this age group. … Further studies are needed to elucidate how distress is associated with adherence with medication and engagement with services, as well as intervention studies to evaluate the effectiveness of approaches in reducing the identified sleep difficulties, mental health problems and addressing illness beliefs,” the researchers concluded – by Melinda Stevens

Disclosure: Samyn reports no relevant financial disclosures. One researcher reports consulting for Promethera and Audentis; and another researcher is on the speakers bureau of Astrellas.