{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T10:02:00Z","timestamp":1790071320006,"version":"4.0.1"},"reference-count":42,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,4,7]],"date-time":"2013-04-07T00:00:00Z","timestamp":1365292800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Depression and anxiety are common in patients with nonalcoholic fatty liver disease (\n                      <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content>\n                      ). However, their associations with histological severity of\n                      <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content>\n                      are unknown.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>\n                      This study examined the association(s) of depression, anxiety and antidepressant pharmacotherapy with severity of histological features in patients with\n                      <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We analysed 567 patients with biopsy\u2010proven\n                      <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content>\n                      enrolled in the Duke\n                      <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content>\n                      Clinical Database. Depressive and anxiety symptoms were assessed using the Hospital Anxiety &amp; Depression Scale (\n                      <jats:styled-content style=\"fixed-case\">HADS<\/jats:styled-content>\n                      ). The associations of depression and anxiety with severity of histological features of\n                      <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content>\n                      were analysed using multiple logistic (or ordinal logistic) regression models with and without adjusting for confounding factors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>\n                      Subclinical and clinical depression was noted in 53% and 14% of patients respectively. Subclinical and clinical anxiety was noted in 45% and 25% of patients respectively. After adjusting for confounders, depression was significantly associated with more severe hepatocyte ballooning in a dose\u2010dependent manner (likelihood ratio test,\n                      <jats:italic>P\u00a0<\/jats:italic>\n                      =\n                      <jats:italic>\u00a0<\/jats:italic>\n                      0.0201); adjusted cumulative odds ratio (\n                      <jats:styled-content style=\"fixed-case\">COR<\/jats:styled-content>\n                      ) of subclinical and clinical depression for having a higher grade of hepatocyte ballooning were 2.1 [95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      , 1.0, 4.4] and 3.6 [95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      , 1.4, 8.8].\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      In patients with\n                      <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content>\n                      , depression was associated with more severe hepatocyte ballooning. Further investigation exploring pathobiological mechanisms underlying the observed associations and potential effects of antidepressant pharmacotherapy on\n                      <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content>\n                      liver histology is warranted.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.12165","type":"journal-article","created":{"date-parts":[[2013,3,14]],"date-time":"2013-03-14T20:34:16Z","timestamp":1363293256000},"page":"1062-1070","source":"Crossref","is-referenced-by-count":163,"title":["Associations of depression, anxiety and antidepressants with histological severity of nonalcoholic fatty liver disease"],"prefix":"10.1111","volume":"33","author":[{"given":"Nagy A.","family":"Youssef","sequence":"first","affiliation":[{"name":"Department of Psychiatry Duke University Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manal 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