Association between psychological distress and liver disease mortality: a meta-analysis of individual study participants

Russ, Tom C.; Kivim�ki, Mika; Morling, Joanne R.; Starr, John M.; Stamatakis, Emmanuel; Batty, G. David

Abstract

Background & Aims: Risk factors for cardiovascular disease, such as obesity and hypertension, have been associated with non-alcoholic fatty liver disease. Psychological distress (symptoms of anxiety and depression) is a risk factor for cardiovascular disease, so it might also be associated, directly or indirectly, with elevated rates of liver disease. We investigated the relation of psychological distress (measured by the 12-item General Health Questionnaire; GHQ) with liver disease mortality.

Methods: We performed a meta-analysis of data from individual participants in 16 prospective studies of the general population of the UK, initiated from 1994 through 2008. We categorized GHQ score into four groups: zero (no distress), 1-3, 4-6, and 7-12.

Results: We used data from 166,631 individuals (55% women; age, 46.6±18.4 years; range, 16−102 years). During a mean follow-up period of 9.5 years, 17,368 participants died (457 with liver disease). We found a significant increase in risk for liver disease mortality as GHQ score increased across categories (ptrend<0.001). The age- and sex-adjusted hazard ratio for the highest GHQ category (7-12) compared to those scoring zero was 3.48 (95% confidence interval, 2.68−4.52). After adjustment for health behaviors, socioeconomic status, body mass index, and diabetes, the hazard ratio was partially attenuated to 2.59 (95% confidence interval, 1.82–3.68).

Conclusions: Our novel finding that psychological distress was associated with liver disease mortality requires testing in other studies. Though results are unlikely to be causal, we provide further evidence for the deleterious effects of psychological problems on physical health.

Citation

Russ, T. C., Kivimäki, M., Morling, J. R., Starr, J. M., Stamatakis, E., & Batty, G. D. (in press). Association between psychological distress and liver disease mortality: a meta-analysis of individual study participants. Gastroenterology, 148(5), Article 958-966.e4. https://doi.org/10.1053/j.gastro.2015.02.004

• Journal Article Type: Article
• Acceptance Date: Feb 2, 2015
• Online Publication Date: Feb 10, 2015
• Deposit Date: May 23, 2018
• Publicly Available Date: May 23, 2018
• Journal: Gastroenterology
• Print ISSN: 2308-2097
• Electronic ISSN: 2518-7880
• Publisher: Publishing House Zaslavsky
• Peer Reviewed: Peer Reviewed
• Volume: 148
• Issue: 5
• Article Number: 958-966.e4
• DOI: https://doi.org/10.1053/j.gastro.2015.02.004
• Keywords: Steatosis, Cirrhosis, Mental health, GHQ-12; Death
• Public URL: https://nottingham-repository.worktribe.com/output/745221
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S001650851500195X?via%3Dihub
• Contract Date: May 23, 2018