Global prevalence and predictors of depression and anxiety in patients with liver cirrhosis: a systematic review and meta-analysis.

Abstract

Background: Liver cirrhosis is a complex disorder that affects nearly 122 million patients worldwide. This study synthesizes global prevalence estimates of depression and anxiety among patients with cirrhosis, together with associated risk factors and geographic distribution.

Method: An electronic search was conducted on Medline, Embase, Cochrane Central and Web of Science databases. Results were then filtered according to the inclusion criteria over two stagesData from eligible studies were extracted into a standardized spreadsheet, which was then subjected to analysis and evidence synthesis.

Results: Our search yielded 23 articles from countries all over the world describing 979,113 patients.The pooled prevalence was 0.37 [95% C.I. 0.29-0.46, p = 0.01] for depression and of 0.53 [95% C.I. 0.33-0.73, p < 0.010] for anxiety, in cirrhotic patients, however, high heterogeneity was noted. Meta-regression was performed to assess the ability of demographic factors (Ager, Sex), and etiological factors to predict depression in cirrhotic patients. Age, alcoholism, and viral etiologies, were linked to depression incidence. Advancing age was associated with increased depression prevalence among cirrhosis patients (p = 0.02).

Conclusion: Depression and anxiety substantially impair quality of life in patients with cirrhosis, but their diagnosis remains limited and under-investigated. Standardizing depression and anxiety screening for cirrhosis patients can improve their outcomes and quality of life significantly.