The summaries are free for public
use. The Chronic Liver Disease
Foundation will continue to add and
archive summaries of articles deemed
relevant to CLDF by the Board of
Trustees and its Advisors.
Abstract Details
Incidence of Depression and Anxiety in a Cohort of Adolescents with Nonalcoholic Fatty Liver Disease
J Pediatr Gastroenterol Nutr. 2020 Dec 16;Publish Ahead of Print.doi: 10.1097/MPG.0000000000003024. Online ahead of print.
1Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Diego School of Medicine, La Jolla, California University of California Berkeley, Berkeley, California Georgetown University School of Medicine, Washington, District of Columbia Amherst College, Amherst, Massachusetts Department of Psychiatry, Kaiser Permanente, Antioch, California Department of Gastroenterology, Rady Children's Hospital, San Diego, California.
Abstract
Objectives: To determine the incidence of clinically diagnosed depression and anxiety in adolescents with NAFLD.
Methods: This was a prospective, longitudinal cohort study between January 1, 2012 and July 1, 2018 conducted in a Children's Hospital Pediatric Gastroenterology Clinic. Participants included adolescents age 12-17 years at baseline with biopsy-confirmed NAFLD. The primary outcomes were having depression and/or anxiety based upon a clinical diagnosis established by a physician or psychologist. The rates of depression and anxiety were measured at baseline and longitudinally throughout follow-up.
Results: 160 adolescents with NAFLD were followed for a mean of 3.8 years. At baseline, 8.1% had a diagnosis of depression. During follow-up, an additional 9.5% (95% CI, 4.7%-14.3%) developed depression. The incidence density of depression was 27 new cases per 1000 person-years at risk. In adolescents with NAFLD, 6.3% had anxiety at baseline and 6.7% (95% CI, 2.6%-10.7%) developed anxiety during follow-up. The incidence density of anxiety was 18 new cases per 1000 person-years at risk. The change in alanine aminotransferase was significantly worse for adolescents with NAFLD who developed depression compared to those who did not develop depression (p < 0.01).
Conclusions: Adolescents with NAFLD had a high incidence of clinically diagnosed depression and anxiety. The rates were higher than expected relative to the available data in the general population. Addressing this mental health burden will require efforts at both the patient level and the systems level.