Depression, Anxiety and Stress in Egyptian Patients with Chronic Liver Diseases

Document Type : Original Article

Authors

1 Family Medicine department, Faculty of Medicine, Zagazig University, Egypt.

2 Internal Medicine department, Faculty of Medicine, Zagazig University, Egypt

Abstract

Background: Patients with chronic liver disease (CLD) can suffer from varied degrees of depression and anxiety. Objectives: to determinate the frequency and severity of depression, anxiety and stress in patients with CLD and to identify the relation between sociodemographic, disease-specific factors and depression, anxiety and stress among those patients.
Methods: A cross-sectional study was done in internal medicine outpatient clinic, Zagazig university hospital in the period from June to December 2018. A questionnaire including personal characteristics and etiology of CLD was filled in. The diagnosis of CLD was confirmed by using combination of clinical signs, symptoms, laboratory investigations and ultrasonography. The severity of liver disease was quantified using modified Child-Pugh classification. Mental health was assessed using Depression Anxiety Stress Scale (DASS-21) questionnaire.
Results: More than one fourth of cases had mild depression while 16.5% of them had moderate depression. The same percentage reported extremely severe anxiety and severe stress. There are statistically significant differences between gender, patient education, ascites, child pough classification, comorbid diabetes and mean depression, anxiety and stress scores. Comorbid diabetes and decompensated cirrhosis significantly increase risk of depression by 3.84 and 17.7 folds respectively. Absence of comorbid hypertension and being illiterate were protective factors against anxiety or stress. Absence of diabetes protects against stress.
Conclusion: Psychiatric symptoms were frequent among patients with CLD. Comorbid diabetes and decompensated cirrhosis increase risk of depression while absence of hypertension and illiteracy were protective factors against both anxiety and stress symptoms.

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