4.7 Article

Depression and Anxiety Are Common Among Patients With Cirrhosis

期刊

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
卷 20, 期 1, 页码 194-+

出版社

ELSEVIER SCIENCE INC
DOI: 10.1016/j.cgh.2020.08.045

关键词

Psychiatric Illness; Liver Disease; Comorbidity; Cirrhosis; Depression; Anxiety

资金

  1. National Cancer Institute [R01 CA212008]
  2. Cancer Prevention Research Institute of Texas [RP150587]
  3. Center for Gastrointestinal Development, Infection and Injury (National Institute of Diabetes and Digestive and Kidney Diseases) [P30 DK 56338]
  4. Center for Innovations in Quality, Effectiveness and Safety [CIN 13-413]
  5. Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development
  6. Michael E. DeBakey VA Medical Center Health Services Research and Development Center of Excellence [HFP90-020]

向作者/读者索取更多资源

This study examined the prevalence and risk factors for depression and anxiety among patients with cirrhosis in the United States. It found that nearly 1 in 6 patients with cirrhosis have moderately severe to severe depression and nearly half have moderate-severe anxiety. Self-reported poor health was identified as a significant risk factor for both depression and anxiety.
BACKGROUND & AIMS: Depression and anxiety can have negative effects on patients and are important to treat. There have been few studies of their prevalence among patients with cirrhosis. We aimed to characterize the prevalence and risk factors for depression and anxiety in a large multi-center cohort of patients with cirrhosis. METHODS: We conducted a telephone-based survey of patients with cirrhosis at 3 health systems in the United States (a tertiary-care referral center, a safety net system, and a Veterans hospital) from April through December 2018. Of 2871 patients approached, 1021 (35.6%) completed the survey. Depression and anxiety were assessed using the PHQ-9 (range 0-25) and STAI (range 20-80) instruments, with clinically significant values defined as PHQ-9 >= 15 and STAI >= 40. We performed multivariate logistic regression analysis to identify factors associated with significant depression and anxiety. RESULTS: The median PHQ-9 score was 7 (25th percentile-75th percentile, 3-12) and the median STAI score was 33 (25 th percentile-75 th percentile, 23-47); 15.6% of patients had moderately severe to severe depression and 42.6% of patients had high anxiety. In multivariable analyses, self-reported poor health (odds ratio [OR], 4.08; 95% CI, 1.79-9.28), being widowed (OR, 2.08; 95% CI, 1.07-4.05), fear of hepatocellular carcinoma (OR, 1.89; 95% CI, 1.04-3.42), higher household income (OR, 0.30; 95% CI, 0.10-0.95), and Hispanic ethnicity (OR, 0.57; 95% CI, 0.33-0.97) were associated with moderately severe to severe depression. Male sex (OR, 0.71; 95% CI, 0.51-0.98), self-reported poor health (OR, 2.73; 95% CI, 1.73-4.32), and fear of hepatocellular carcinoma (OR, 2.24; 95% CI, 1.33-3.78) were associated with high anxiety. CONCLUSIONS: Nearly 1 in 6 patients with cirrhosis have moderately severe to severe depression and nearly half have moderate-severe anxiety. Patients with cirrhosis should be evaluated for both of these disorders.

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