title: Depression, anxiety and alexithymia symptoms are major determinants of health related quality of life (HRQoL) in cirrhotic patients.
abstract: HRQoL is impaired in cirrhosis. Establishing the relevance of depression, anxiety, alexithymia and cirrhosis stage on the patients' HRQoL. Sixty cirrhotics underwent a neuropsychological assessment, including ZUNG-SDS, STAI Y1-Y2 and TAS-20. Minimal hepatic encephalopathy (MHE) was detected by PHES, HRQoL by Short-Form-36 (SF-36). Depression was detected in 34 patients (57 %, 95%CI = 44-70 %), state-anxiety in 16 (27 %, 95%CI = 15-38 %), trait-anxiety in 17 (28 %, 95%CI = 17-40 %), alexithymia in 14 (31 % 95%CI = 16-46 %) and MHE in 22 (37 %, 95%CI = 24-49 %). Neuropsychological symptoms were unrelated to cirrhosis stage, hepatocellular carcinoma or MHE. A significant correlation was observed among psychological test scores and summary components of SF-36. At multiple linear regression analysis including Child-Pugh and MELD scores, previous-HE and the psychological test scores as possible covariates, alexithymia and depression as well as to the Child-Pugh score were significantly related to the SF-36 mental component; while trait-anxiety was the only variable significantly and independently related to the SF-36 physical component. Depression, state and trait-anxiety and alexithymia symptoms are frequent in cirrhotics and are among the major determinants of the altered HRQoL.
authors.affiliation: Department of Clinical Medicine, Centre for Diagnosis and Treatment of Portal Hypertension, Sapienza University of Rome, Rome, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Nardelli
authors.forename: Ilaria
authors.initials: I
authors.lastname: Pentassuglio
authors.forename: Chiara
authors.initials: C
authors.lastname: Pasquale
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Ridola
authors.forename: Federica
authors.initials: F
authors.lastname: Moscucci
authors.forename: Manuela
authors.initials: M
authors.lastname: Merli
authors.forename: Concetta
authors.initials: C
authors.lastname: Mina
authors.forename: Massimo
authors.initials: M
authors.lastname: Marianetti
authors.forename: Mariangela
authors.initials: M
authors.lastname: Fratino
authors.forename: Chiara
authors.initials: C
authors.lastname: Izzo
authors.forename: Carlo
authors.initials: C
authors.lastname: Merkel
authors.forename: Oliviero
authors.initials: O
authors.lastname: Riggio
mesh_terms: D000342:Affective Symptoms / Q000209:etiology / Q000523:psychology*; D000368:Aged; D001007:Anxiety / Q000209:etiology / Q000523:psychology*; D003863:Depression / Q000209:etiology / Q000523:psychology*; D005260:Female; D006501:Hepatic Encephalopathy / Q000209:etiology / Q000401:mortality / Q000523:psychology; D006801:Humans; D016014:Linear Models; D008103:Liver Cirrhosis / Q000401:mortality / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012307:Risk Factors; D016019:Survival Analysis