title: Association of chronic liver disease with depression: a population-based study.
abstract: OBJECTIVE
  Chronic 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.
  
  
  METHODS
  We 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.
  
  
  RESULTS
  The 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.
  
  
  CONCLUSIONS
  Although depression has been suspected to be associated with a number of CLD, this association remains strong only for CH-C.
authors.affiliation: Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, USA.
authors.forename: Keanu
authors.initials: K
authors.lastname: Lee
authors.forename: Munkhzul
authors.initials: M
authors.lastname: Otgonsuren
authors.forename: Zahra
authors.initials: Z
authors.lastname: Younoszai
authors.forename: Heshaam M
authors.initials: HM
authors.lastname: Mir
authors.forename: Zobair M
authors.initials: ZM
authors.lastname: Younossi
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D003866:Depressive Disorder / Q000453:epidemiology*; D003865:Major Depressive Disorder / Q000453:epidemiology; D005234:Fatty Liver / Q000453:epidemiology; D005260:Female; D006521:Hepatitis, Chronic / Q000453:epidemiology; D006801:Humans; D008107:Liver Diseases / Q000453:epidemiology*; D008108:Liver Diseases, Alcoholic / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D009749:Nutrition Surveys; D016017:Odds Ratio