Abstract
Background & AimsTo evaluate the risk of depressive disorders among non-alcoholic patients by using the Taiwan National Health Insurance Research Database (NHIRD).MethodsWe conducted a retrospective study of a matched cohort of 52 725 participants (10 545 non-alcoholic cirrhotic patients and 42 180 control patients) who were selected from the NHIRD. Patients were observed for a maximum of 11 years to determine the rates of newly onset depressive disorders, and Cox regression was used to identify the risk factors associated with depressive disorders in cirrhotic patients.ResultsDuring the 11-year follow-up period, 395 (3.75%) non-alcoholic cirrhotic patients and 1 183 (2.80%) control patients were diagnosed with depressive disorders. The incidence risk ratio of depressive disorders between non-alcoholic cirrhotic patients and control patients was 1.76 (95% CI, 1.57–1.98, P<.001). After adjusting for age, sex, and comorbidities, non-alcoholic cirrhotic patients were 1.75 times more likely to develop depressive disorders (95% CI, 1.56–1.96, P<.001) compared with the control patients. The hazard ratios for patients younger than 60 years old (1.31) and female (1.25) indicated that each is an independent risk factor for depressive disorders in non-alcoholic cirrhotic patients.ConclusionsThe likelihood of developing depressive disorders is greater among non-alcoholic cirrhotic patients than among patients without cirrhosis. Symptoms of depression should be sought in patients with cirrhosis.
Highlights
Cirrhosis is a consequence of chronic liver disease characterized by the replacement of liver tissue by fibrosis, scar tissue, and regenerative nodules, which leads to loss of liver function
The National Health Insurance Research Database (NHIRD) is managed by the National Health Research Institutes (NHRI) and confidentiality is maintained according to the directives of the Bureau of the National Health Insurance (NHI)
Incidence Rate of Depressive Disorders During the study period, 395 (3.75%) non-alcoholic cirrhotic patients and 1 183 (2.80%) control patients were diagnosed with depressive disorders
Summary
Cirrhosis is a consequence of chronic liver disease characterized by the replacement of liver tissue by fibrosis, scar tissue, and regenerative nodules, which leads to loss of liver function. Previous studies focusing on depression in cirrhotic patients [2,3,4,5,6,7,8] have addressed alcoholic cirrhosis, establishing whether the reported depression was related to alcohol or cirrhosis is difficult because alcohol users have been highly associated with psychiatric disorders, especially depressive disorders [9,10,11,12,13,14] In these studies, depression was often evaluated using rating scales, such as the Beck depression inventory or the Hamilton depression rating scale, rather than diagnosis by a physician. To evaluate the risk of depressive disorders among non-alcoholic patients by using the Taiwan National Health Insurance Research Database (NHIRD)
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