Adolescents with chronic liver disease have higher rates of anxiety and depression
Young people who have undergone liver transplant (LT), or have autoimmune liver disease (AILD), or other chronic liver diseases have higher rates of depression and anxiety than the general adolescent population, according to a study presented at the 49th Annual Meeting of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) 2016 held in Athens, Greece.
To assess the prevalence of anxiety and depression in young people with LT, AILD, or chronic liver disease, 232 young people attending a liver transition clinic were given an electronically-administered questionnaire, 187 of whom participated in this study. [ESPGHAN 2016, abstract H-O-007]
Almost 18 percent of young people (mean age 18 years) attending the clinic reported having anxiety and depression, with 9.7 percent reporting probable major depressive disorder (MDD), and 2.2 percent having suicidal ideation. About 14 percent had probable anxiety disorder, with 5.4 percent having severe anxiety symptoms.
“These [findings] are higher than the estimated prevalence rates of anxiety or depression in the general adolescent population [about 6 percent],” said the study authors.
The most common reasons cited for distress were fatigue (42.3 percent), money problems (30.8 percent), worry (30.2 percent), problems at work or school (29.1 percent), low self-esteem (27.5 percent), and sleep difficulties (27.5 percent).
Items on the questionnaire pertained to concern and understanding of illness, impact of illness on life (consequences), how long the participants expected to have the illness (timeline), symptoms experienced (identity), and emotional effects of illness (emotional response). Participants were also asked if they thought treatment could help them with their condition (treatment control), and the amount of control they thought they had over their illness (personal control).
Elevated levels of depression and anxiety were significantly associated with higher perceived illness consequences, identity, concern, emotional response, and reduced perceptions of personal control, while there was no association between depression or anxiety and understanding of illness or treatment control.The authors advocated for routine holistic care which included mental health screening and interventions for illness beliefs for this age group.