Health attributions predict anxiety and depression in patients with autoimmune hepatitis

Aims: Our study aimed to assess the impact of autoimmune hepatitis (AIH) on mental health. Methods: Consecutive AIH-patients of an outpatient clinic for liver diseases were asked to answer a set of validated self-assessments including the Patient Health Questionnaire (PHQ) and the SF–12. Clinical data were drawn from the medical records. Results: 103 AIH-patients participated (age 50±18, 71% female). They had significantly higher depression (PHQ–9: 6.1±5.8) and anxiety scores (GAD–7: 4.3±4.7) than the German general population (2.5±3.5 and 2.9±3.3, respectively). 12.5% of the patients reported rather severe anxiety symptoms (GAD–7≥10), 10.8% fulfilled the criteria for major depression in the PHQ. Overall, their mental health status was significantly reduced compared to the general population (MCS of SF–12: 46.0±12.0 vs. 49.9±10.1), not significantly differing from cancer-patients (47.7±10.7). Regression analysis revealed concerns regarding the consequences of the liver disease as the most important predictor for depression (β=.39) and anxiety (β=.46), whereas cirrhosis status and the number of years of known diagnosis did not predict these outcomes. Depression was significantly related to steroid medication (β=.26), but unrelated to laboratory findings. Conclusions: AIH impacts the mental health of the patients, independent from their medical condition. Dysfunctional health attributions may play a role to explain this finding.

Anxiety - Autoimmune Hepatitis - Depression - Mental Health