Abstract
The impact of depression (assessed by the BeckDepression Inventory) on quality of life and outcome wasprospectively assessed in adult patients with cirrhosis.Patients with depression had significantly poorer perceived quality of life (P = 0.006),poorer adaptive coping (P = 0.001), and lower functionalstatus, ie, Karnofsky performance score (P = 0.06), ascompared to the nondepressed patients. Survival after transplantation was not different betweendepressed and nondepressed patients. However, thepatients with depression were significantly more likelyto die while awaiting transplantation than thenondepressed patients (P = 0.02). The difference inmortality between the depressed and the nondepressedpatients with end-stage liver disease could not beexplained by the severity of illness variables;Child-Pugh score, complications of liver disease, renal function,serum albumin, prothrombin time, frequency and durationof hospitalizations were not significantly different fordepressed and nondepressed patients. Symptoms of depression should be sought in patients withcirrhosis since depression is a modifiable illness thatis amenable to treatment.
Similar content being viewed by others
REFERENCES
Wells KB, Stewart A, Hays RD, Burnam A, Rogers W, Daniels M, Berry S, Greenfeld S, Ware J: The functioning and well-being of depressed patients. Results from the medical outcomes study. JAMA 262:914–919, 1989
Frasure-Smith N, Lesperance F, Talajic M: Depression following myocardial infarction, impact on 6-month survival. JAMA 270:1819–1825, 1993
Ahern DK, Gorkin L, Anderson JL, et al: Biobehavioral variables and mortality or cardiac arrest in the cardiac arrhythmia pilot study. Am J Cardiol 66:59–62, 1990
Roose SP, Alack GW, Woodrings: Death, depression, and heart disease. J Clin Psychiatry 52(suppl):34–39, 1991
Shekelle RB, Raynor WJ, Ostfeld A, et al: Psychological depression and 17 year risk of death from cancer. Psychosom Med 43:117–125, 1981
Wassertheil-Smoller S, Applegate WB, Berge K, Chang CJ, Davis BR, Grimm R, Kostis J, Pressel S, Schron E: Change in depression as a precursor of cardiovascular events. Arch Intern Med 156:553–561, 1996
Rodriguz JR, Davis GL, Howard RJ, Brunson ME, Langham MR, Haiman S: Psychological adjustment of liver transplant candidates. Clin 7:227–229, 1993
Bonsel GJ, Essink-Bot ML, Klompmaker IJ, Slooff MJH: Assessment of the quality of life before and following transplantation. Transplantation 53:796–800, 1992
Beck AT, Ward CH, Mendelson M: An inventory for measuring depression. Arch Gen Psychiatry 6:561–571, 1961
Perry S, Fishman B, Jacobberg L, Frances A: Relationship over one year between lymphocyte subsets and psychosocial variables among adults with infection by human immunodeficiency virus. Arch Gen Psychiatry 49:396–401, 1992
Perez-Stable EJ, Miranda J, Munoz RF, Ying YW: Depression in medical outpatients: Underrecognition and misdiagnosis. Arch Intern Med 150:1083–1088, 1990
Mulrow CD, Williams JW, Gerety MB, Ramirez G, Montiel OM, Kerber C: Case-finding instruments in depression in primary care settings. Ann Intern Med 122:913–921, 1995
Namir S, Wolcott DL, Fawzy FI, et al: Coping with AIDS: Psychological and health implications. Appl Soc Psychiatry 17:309–328, 1987
Singh N, Squier C, Sivek C, Wagener MM, Nguyen MH, Goetz A, Yu VL: Determinants of compliance in patients with human immunodeficiency syndrome: Prospective assessment with implications for enhancing compliance. AIDS Care 8:261–269, 1996
Grieco A, Long CJ: Investigation of the Karnofsky performance status as a measure of quality of life. Health Psychol 3:129–142, 1984
Sherlock S, Dooley J: Hepatic cirrhosis. In Diseases of the Liver and Biliary System, 9th ed. S Sherlock, J Dooley (eds). London, Blackwell Scientific Publications 1993, pp 357–369
Ruberman W, Weinblatt E, Goldberg JD, Chaudhry BS: Psychosocial influences or mortality after myocardial infarction. N Engl J Med 311:552–559, 1984
Case RB, Moss J, Case N, et al: Living alone after myocardial infarction: Impact on prognosis. JAMA 267:515–519, 1992
Haga DA, Dyck MJ, Ernst D: Empirical status of cognitive theory of depression. Psychol Bull 110:215–236, 1991
Lorr M, Daston P, Smith IR: An analysis of mood states. Educ Psychol Meas 27:89–96, 1967
Joffe RT, Lippert GP, Gray TA, Sawa G, Horvath Z: Mood disorder and multiple sclerosis. Arch Neurol 44:376–378, 1987
Black DW, Warrack G, Winokur G: Excess mortality among psychiatric patients. The Iowa record-linkage study. JAMA 253:58–61, 1985
Irwin M, Daniels M, Bloom ET, Smith TL, Weiner H: Life events, depressive symptoms and immune function. Am J Psychiatry 144:437–441, 1987
Bartrop RW, Luckhurst E, Lazarus L, Kiloh LG, Penny R: Depressed lymphocyte function after bereavement. Lancet 1:834–836, 1977
Landmann RM, Muller FB, Perini C, et al: Changes of immunoregulatory cells induced by psychological and physical stress: Relationship to plasma catecholamines. Clin Exp Immunol 58:127–135, 1984
Keller SE, Schleifer SJ, Liota AS, et al: Stress induced alterations of immunity in hypophysectomized rats. Proc Natl Acad Sci USA 85:9297–9301, 1988
Koff WC, Fann AV, Dunegan MA, et al: Caltecholamine-induced suppression of interleukin 1 production. Lymphokine Res 5:239–247, 1986
Vanhoutte PM: Platelet-derived serotonin, the endothelium and cardiovascular disease. J Cardiovasc Pharmacol 17(suppl 5):6–12, 1991
Meltzer HY, Arora RC: Platelet serotonin studies in affective disorders: Evidence for a serotonin abnormality? In W Sandler, A Doppen, S Harnett (eds). 5-Hydroxytryptamine in Psychiatry. Oxford, Oxford University Press, 1991, pp 50–89
Rights and permissions
About this article
Cite this article
Singh, N., Gayowski, T., Wagener, M.M. et al. Depression in Patients with Cirrhosis (Impact on Outcome). Dig Dis Sci 42, 1421–1427 (1997). https://doi.org/10.1023/A:1018898106656
Issue Date:
DOI: https://doi.org/10.1023/A:1018898106656