Depression and anxiety · 2026
Magnitude and Associated Factors of Depressive Symptoms Among Adult Patients With Cirrhosis: An Experience From a Resource-Limited Setting.
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Dissassa Gashahun Mekonnen, Kube Geda Lelisa, Fisseha Henok, Mekonnen Eyoel Berhan, Dinka Dirbe Jebesa, Ashine Amare Hailu, Woyimo Tamirat Godebo
Аннотация
OBJECTIVE: Depression is a common comorbidity in cirrhosis, yet its burden and determinants are poorly characterized in sub-Saharan Africa. This study aimed to determine the magnitude and factors associated with depression among adult patients with cirrhosis at a tertiary hospital in Ethiopia.
METHODS: In a hospital-based cross-sectional study, 134 adult patients with cirrhosis were consecutively recruited from a hepatology clinic in Addis Ababa. Depressive symptoms were assessed using the patient health questionnaire-9 (PHQ-9), with a score ≥10 indicating clinically significant depressive symptoms. Sociodemographic and clinical data, including cirrhosis etiology, disease stage, MELD score, and social support (3-item Oslo social support scale [OSS-3]), were collected via interview and chart review. Multivariable logistic regression was used to identify factors independently associated with clinically significant depressive symptoms.
RESULTS: Twelve of 134 participants (9.0%; 95% CI: 5.3%-15.1%) had clinically significant depressive symptoms based on a PHQ-9 score ≥10. In adjusted analyses, longer illness duration (adjusted odds ratio [AOR] = 1.48, 95% CI: 1.12-1.96), decompensated cirrhosis was associated with approximately nine-fold higher odds of clinically significant depressive symptoms compared with compensated cirrhosis, and a higher MELD score (AOR = 1.58, 95% CI: 1.21-2.06) were significantly associated with increased odds of depression. The absence of comorbid chronic illness was also independently associated with lower depression odds (AOR = 0.14, 95% CI: 0.03-0.72, p = 0.018). Conversely, moderate (AOR = 0.18, 95% CI: 0.04-0.79) and strong (AOR = 0.04, 95% CI: 0.01-0.64) social support were associated with lower odds of clinically significant depressive symptoms, although the cross-sectional design precludes conclusions about causality and reverse causation (i.e., depressed individuals may underreport social support) cannot be excluded.
CONCLUSION: Clinically significant depressive symptoms were identified in 9.0% of adults with cirrhosis. More advanced liver disease and poorer social support were associated with depressive symptoms. These findings underscore the critical need for integrated mental health screening and psychosocial interventions within routine cirrhosis care in resource-limited settings.
METHODS: In a hospital-based cross-sectional study, 134 adult patients with cirrhosis were consecutively recruited from a hepatology clinic in Addis Ababa. Depressive symptoms were assessed using the patient health questionnaire-9 (PHQ-9), with a score ≥10 indicating clinically significant depressive symptoms. Sociodemographic and clinical data, including cirrhosis etiology, disease stage, MELD score, and social support (3-item Oslo social support scale [OSS-3]), were collected via interview and chart review. Multivariable logistic regression was used to identify factors independently associated with clinically significant depressive symptoms.
RESULTS: Twelve of 134 participants (9.0%; 95% CI: 5.3%-15.1%) had clinically significant depressive symptoms based on a PHQ-9 score ≥10. In adjusted analyses, longer illness duration (adjusted odds ratio [AOR] = 1.48, 95% CI: 1.12-1.96), decompensated cirrhosis was associated with approximately nine-fold higher odds of clinically significant depressive symptoms compared with compensated cirrhosis, and a higher MELD score (AOR = 1.58, 95% CI: 1.21-2.06) were significantly associated with increased odds of depression. The absence of comorbid chronic illness was also independently associated with lower depression odds (AOR = 0.14, 95% CI: 0.03-0.72, p = 0.018). Conversely, moderate (AOR = 0.18, 95% CI: 0.04-0.79) and strong (AOR = 0.04, 95% CI: 0.01-0.64) social support were associated with lower odds of clinically significant depressive symptoms, although the cross-sectional design precludes conclusions about causality and reverse causation (i.e., depressed individuals may underreport social support) cannot be excluded.
CONCLUSION: Clinically significant depressive symptoms were identified in 9.0% of adults with cirrhosis. More advanced liver disease and poorer social support were associated with depressive symptoms. These findings underscore the critical need for integrated mental health screening and psychosocial interventions within routine cirrhosis care in resource-limited settings.