Female gender and gastrointestinal symptoms, not brain-derived neurotrophic factor, are associated with depression and anxiety in cirrhosis.

Aim: Cirrhosis places a substantial burden on the psychological status of affected individuals. The aim of our study was to identify the associated factors of psychological distress in cirrhosis.

Methods: A total of 208 patients with cirrhosis were recruited. Each patient received validated questionnaires to assess gastrointestinal (GI) symptoms, depression, and anxiety. Serum brain-derived neurotrophic factor (BDNF) levels were measured by enzyme-linked immunosorbent assay.

Results: A total of 16.35% of patients (n = 34) were diagnosed with depression and 10.58% (n = 22) with anxiety. The percentages of female patients among those diagnosed with depression and anxiety were 58.8% and 77.3%, respectively, which were significantly higher than that in non-depressed (35.1%) and non-anxious patients (34.4%). The patients who showed more GI symptoms had higher depression and anxiety scores. The GI symptom scores of patients with depression and anxiety were 4 (2.75, 7) and 4 (2.75, 7.25), respectively, which were significantly higher than that of patients without depression (2 [0, 4]) and anxiety (2 [1, 4]). Significantly higher depression and anxiety scores were detected in patients who suffered from abdominal bloating, belching, anorexia, abdominal pain, nausea/vomiting, and constipation. Cirrhotic patients had higher serum levels of BDNF than healthy controls (159.33 [96.64, 243.30] pg/mL vs. 70.74 [56.58, 93.52] pg/mL). In the cirrhosis group, there was no significant difference in BDNF levels between depressed and non-depressed patients. Multiple linear regression analysis revealed that depression and anxiety were each independently associated with female gender and GI symptom scores.

Conclusions: Female gender and GI symptoms are closely associated with depression and anxiety in cirrhosis. There is no significant correlation between BDNF level and psychological distress in cirrhosis.