Health-related quality of life, depression, and anxiety in patients with autoimmune hepatitis

Abstract

Background & aims: Improving health related quality of life (HrQoL) in patients with chronic diseases such as autoimmune hepatitis (AIH) should be a major treatment goal. However, little is known on the HrQoL in patients with AIH, and the topic is not given attention in current practice guidelines. We therefore conducted a single center study evaluating HrQoL in 103 consecutive outpatients with AIH.

Methods: Patient-reported HrQoL data were analysed in relation to clinical disease parameters and compared to representative data of the German population as well as control patients.

Results: Based on patient-reported data, a major depressive syndrome (10.8%) was found to be five times more frequent in AIH patients compared to the general population (p<0.001). The rate of severe symptoms of anxiety was also found to be significantly increased compared to the general population (p=0.006). In seven of the eleven patients who scored for a major depressive syndrome a psychiatric comorbidity had not been diagnosed before. Major factors associated with depression and anxiety were concerns with regard to the progression of the liver disease.

Conclusions: This study identified--for the first time--a high rate of previously unrecognized severe symptoms of depression and anxiety in patients with AIH. Of importance for daily clinical practice, the factors associated with these symptoms may in part be amenable to targeted counselling and adequate treatment of the disease, thereby offering the chance to improve the care and HrQoL of AIH-patients.

Keywords: 12-item short form health survey; 7-item generalized anxiety disorder screener; 9-item pepression module from the patient health questionnaire; AIH; Anxiety; Autoimmune hepatitis; Depression; GAD-7; Health-related quality of life; HrQoL; MDS; ODS; PHQ-9; SF-12; autoimmune hepatitis; health-related quality of life; major depressive syndrome according to PHQ-9 coding algorithm; other depressive syndrome according to PHQ-9 coding algorithm.