The association between hepatic encephalopathy/minimal hepatic encephalopathy and depressive and anxiety disorders: a systematic review.

OBJECTIVES: This review examined the currently available evidence of the association between liver encephalopathy and mood/anxiety disorders. METHOD: English-language studies using the keywords "hepatic encephalopathy," "depression," and "anxiety" were searched through PubMed, Medline, Cochrane Library, and PsycINFO databases. A total of 135 articles were considered for this review, of which 9 were qualitative and quantitative research papers regarding depression and anxiety in hepatic encephalopathy (HE). RESULTS: There is a significant discrepancy between the research method of the studies and their outcomes. The number of studies suggesting a relationship between HE and mood/anxiety disorders is slightly higher than that of studies with opposite results; however, based on the current evidence, it is difficult to conclude a significant association between these two conditions. CONCLUSION: More longitudinal studies that include face-to-face psychiatric assessments are required to highlight any possible association between depressive/anxiety disorders and HE.

Psychiatric risk factors predicting post-liver transplant physical and psychiatric complications: a literature review.

OBJECTIVES: The psychiatric assessment of potential liver transplant recipients is becoming increasingly common in clinical practice. In such assessments, the psychiatrist is invited by the transplant team to assess the patient prior to the patient receiving a transplant liver to identify factors that could predict an unsuccessful post-transplant course, whether this is from a psychiatric or physical perspective. This review examined published research from 2000 to 2014 on psychological risk factors predicting post-transplant physical and psychiatric complications. CONCLUSIONS: Based on the strength of the evidence available, our review identified four risk factors: mood disorders; social supports; substance misuse; and alcohol dependence. These factors could potentially provide a framework to guide the evaluation and prediction of psychological and physical complications post-liver transplantation.