Association of Chronic Liver Disease with Depression: A Population-Based Study

ObjectiveChronic liver diseases (CLD) have been associated with depression. Our aim was to assess the association of different types of CLD with depression in a population-based cohort.MethodsWe examined data from National Health and Nutrition Examination Survey (NHANES 2005–2010). We included adult patients with chronic hepatitis C (CH-C), chronic hepatitis B (CH-B), alcohol-related liver disease (ALD), and nonalcoholic fatty liver disease (NAFLD). Patient Health Questionnaire (PHQ-9) survey was used as a depression screener. Univariate and multivariate analyses were performed to determine independent variables associated with each type of CLD and depression.ResultsThe cohort included 10,231 NHANES participants. After multivariate analysis, CH-C was independently associated with age (OR = 1.05, 95% CI: 1.03–1.07), male gender (OR = 1.88, 95% CI: 1.19–2.97), African American race/ethnicity (OR = 2.50, 95% CI:1.50–4.18), smoking (OR = 6.20, 95% CI: 1.62–23.68), injection drug use (OR = 52.86, 95% CI:32.87–85.03), and depression (OR = 2.87, 95% CI: 1.78–4.62). CH-B was independently associated with being non-Caucasian (for African Americans OR = 5.09, 95% CI: 2.41–10.76, for other races OR = 4.74, 95% CI: 2.32–9.70). ALD was independently associated with younger age (OR = 0.98, 95% CI: 0.96–0.99), male gender (OR = 1.53, 95% CI: 1.19–1.95), Mexican American race/ethnicity (OR = 2.63, 95% CI: 1.87–3.69), and moderate to heavy smoking (OR = 2.08, 95% CI: 1.46–2.96). Finally, presence of insulin resistance [OR = 2.65 95% CI: 1.98–3.55], diabetes [OR = 1.54 95% CI: 1.11–2.13], and Mexican American race/ethnicity [OR = 2.03(1.35–3.06)], were predictive of NAFLD.ConclusionsAlthough depression has been suspected to be associated with a number of CLD, this association remains strong only for CH-C.