TitleAssociation Between Psychological Distress and Liver Disease Mortality: A Meta-analysis of Individual Study Participants.
Publication TypeJournal Article
Year of Publication2015
AuthorsRuss, TC, Kivimäki, M, Morling, JR, Starr, JM, Stamatakis, E, Batty, GD
Date Published05/2015
KeywordsAdolescent, Adult, Aged, Aged, 80 and over, Cause of Death, Female, Health Status, Humans, Liver Diseases, Male, Mental Health, Middle Aged, Predictive Value of Tests, Prognosis, Risk Assessment, Risk Factors, Stress, Psychological, Surveys and Questionnaires, Young Adult

BACKGROUND & AIMS: Risk factors for cardiovascular disease, such as obesity and hypertension, have been associated with nonalcoholic 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 liver disease. We investigated the relationship between psychological distress (measured by the 12-item General Health Questionnaire [GHQ]) and liver disease mortality.

METHODS: We performed a meta-analysis of data from individual participants in 16 prospective studies of the general population in the United Kingdom, initiated from 1994 through 2008. Subjects were assigned to groups based on GHQ score: 0 (no distress), 1-3, 4-6, or 7-12.

RESULTS: We analyzed data from 166,631 individuals (55% women; mean ± SD 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 liver disease mortality with increase in GHQ score (Ptrend < .001). The age- and sex-adjusted hazard ratio for the highest GHQ score category (ie, 7-12), compared with the 0 score category, was 3.48 (95% confidence interval: 2.68-4.52). After adjustment for health behaviors, socioeconomic status, body mass index, and diabetes, this hazard ratio decreased to 2.59 (95% confidence interval: 1.82-3.68).

CONCLUSIONS: Based on a meta-analysis, psychological distress is associated with liver disease mortality, although this finding requires additional analysis. Although one is not likely to cause the other, we provide additional evidence for the deleterious effects of psychological problems on physical health.

Alternate JournalGastroenterology
PubMed ID25680670
Grant List / / Medical Research Council / United Kingdom
/ / Biotechnology and Biological Sciences Research Council / United Kingdom
MR/K026992/1 / / Medical Research Council / United Kingdom
MR/K013351/1 / / Medical Research Council / United Kingdom
G0700704 / / Medical Research Council / United Kingdom
R01AG034454 / AG / NIA NIH HHS / United States
R01HL036310 / HL / NHLBI NIH HHS / United States