Young people with liver conditions face an elevated risk of depression and anxiety

Researchers have found that many teens and young adults with chronic liver conditions suffer from depression and anxiety, which can have considerable impacts on their emotional and physical health. The findings, which are published in Liver Transplantation, indicate that greater attention should be directed to the mental health of these young patients.

Adolescence is a challenging time for young people in general, but even more so for those with medical conditions. Young people with chronic illness have higher rates of mental health problems than the general population, which can affect how well they take care of themselves. A team led by Marianne Samyn, MD, FRCPCH and Anna Hames, of King's College Hospital conducted a study to uncover the prevalence of anxiety and depression in young people with chronic liver diseases. They also sought to identify the factors that might cause distress in these young patients and how anxiety and depression might affect their beliefs about their illness and treatment.

For the study, 187 patients aged 16 to 25 years who were attending an outpatient liver transition clinic in London completed an electronically-administered questionnaire. The clinic is a multidisciplinary service dedicated to young patients with a range of liver conditions that aims to provide developmentally appropriate care and a smooth transition between pediatric and adult services. Patients were divided in three groups: those who had undergone liver transplantation, those with autoimmune liver disease, and those with other chronic liver conditions.

Based on the questionnaire, 17.7 percent of the patients in the study screened positive for anxiety or depression, which is significantly higher than the 4 percent to 6 percent prevalence in the general adolescent population. There were no significant differences between disease groups. Patients most frequently attributed their distress to fatigue, sleep difficulties, financial concerns, problems at work/school, worry, and low self-esteem. Depression and anxiety seemed to influence how patients felt their illness affected them emotionally, how concerned they were about their illness, how many symptoms they experienced, and how much impact they felt the illness had on their lives. Depression and anxiety did not have a significant relationship with patients' perceived understanding of their illness or their beliefs as to how much treatment can help.

"Health care professionals should be aware of the high prevalence of mental health problems in young people with liver conditions and routinely inquire about young people's psychosocial circumstances as both can impact on their illness and outcome," said Dr. Samyn. "Interestingly, the most common concerns young people with liver conditions report--such as lethargy, problems with sleeping and money, and work- or school-related issues--are very similar to their peers and can be addressed by a multidisciplinary team looking after them."

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