Impairment of health-related quality of life in functional dyspepsia and chronic liver disease: the influence of depression and anxiety.
BACKGROUND
Health-related quality of life (HRQOL) is a marker of disease severity. Data on the relative impairment of HRQOL in chronic liver disease (CLD) and functional gastrointestinal disorders are lacking and no studies have assessed the link between impairment of HRQOL and psychosocial factors yet.


OBJECTIVE
To assess predictors for, and the impairment of, HRQOL in CLD and FD.


METHODS
In 181 functional dyspepsia (FD) patients, 204 CLD patients and 337 healthy blood donors, HRQOL was assessed with the Short Form-36 (mental and physical component), and anxiety and depression utilizing the Hospital Anxiety and Depression Scale.


RESULTS
Compared with HC, HRQOL is significantly lower in FD and CLD (P-value for all <0.001). The mental but not physical component of HRQOL was significantly more impaired in FD compared with CLD (P < 0.05). After adjusting for confounders, impairment of mental (P < 0.001) and physical (P = 0.005) component of HRQOL was associated with the severity of CLD and FD. In FD, the multivariate analysis revealed depression and severity of symptoms as the most important predictors of HRQOL (R2 = 21.9 and 7.1). In CLD, the mental component of HRQOL was associated with depression and anxiety (R(2) = 9.9 and 9.7).


CONCLUSIONS
In tertiary care, HRQOL is more severely impaired in FD compared with CLD. Co-morbid psychiatric conditions significantly contribute to the impairment of HRQOL.
Haag
S
S
Department of Gastroenterology and Hepatology, University of Essen, Essen, Germany.
Senf
W
W
Häuser
W
W
Tagay
S
S
Grandt
D
D
Heuft
G
G
Gerken
G
G
Talley
N J
NJ
Holtmann
G
G
D000328:Adult; D001008:Anxiety Disorders / Q000145:classification / Q000150:complications*; D002908:Chronic Disease; D003866:Depressive Disorder / Q000145:classification / Q000150:complications*; D004415:Dyspepsia / Q000145:classification / Q000523:psychology*; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000145:classification / Q000175:diagnosis / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires