Table2_Mental health disorder in chronic liver disease: a questionnaire survey.docx

BackgroundThe mental health of patients with chronic liver disease (CLD) warrants greater attention and understanding, especially concerning its risk factors.
MethodPatients from our hospital’s hepatology clinic were consecutively enrolled and completed a questionnaire assessing anxiety, depression, and sleep quality using the GAD-7, PHQ-9, and PSQI scales, respectively. Reliability and validity were evaluated with Cronbach’s α and Kaiser-Meyer-Olkin (KMO). Continuous and categorical variables were analyzed using the Mann-Whitney U and Chi-square tests. Univariate and multivariate logistic regression were used to identify risk factors, while restricted cubic spline (RCS) were used to explored non-linear associations. Subgroup analyses were stratified by sex, age, and education.
ResultA total of 1030 questionnaires were collected, and after quality control, 1003 were included. 56.2% (564/1003), 53.2% (534/1003), and 67.4% (676/1003) individuals had anxiety, depression, and sleep disorders. Differences in age, gender, and education level were observed (P<0.05). Subgroup analysis showed similar demographic trends. Univariate and multivariate regression analysis found age negatively correlated with anxiety (OR=0.98, 95%CI=0.97-0.99, P=0.02) and depression (OR=0.98, 95%CI=0.96-0.99, P<0.001), but positively correlated with sleep disorders (OR=1.03, 95%CI= 1.01-1.05, P< 0.001); males are less prone to anxiety (OR=0.68, 95%CI=0.52-0.88, P=0.004) and sleep disorders (OR=0.72, 95%CI: 0.55-0.94, P=0.02); university degree is more susceptible to depression (OR=1.36, 95%CI=1.04-1.77, P=0.02) and anxiety (OR=1.45, 95%CI=1.11-1.89, P=0.007). RCS analysis suggested a linear relationship between the age and affective disorders among different population.
ConclusionYoung individuals, female, and those with higher education are more vulnerable to mental health, warranting increased attention.

背景 慢性肝病（chronic liver disease, CLD）患者的心理健康状况亟需得到更多关注与深入解析，尤其需聚焦其相关危险因素。
方法 本研究连续纳入我院肝病门诊的慢性肝病患者，采用7条目广泛性焦虑障碍量表（GAD-7）、9条目患者健康问卷（PHQ-9）及匹兹堡睡眠质量指数（PSQI）分别评估受试者的焦虑、抑郁及睡眠质量，所有受试者均完成上述问卷。本研究通过克朗巴赫α系数（Cronbach’s α）与凯泽-迈耶-奥尔金检验（Kaiser-Meyer-Olkin, KMO）评估问卷的信度与效度；连续变量与分类变量分别采用曼-惠特尼U检验（Mann-Whitney U test）与卡方检验进行统计学分析。采用单因素及多因素logistic回归分析筛选危险因素，并通过限制性立方样条（restricted cubic spline, RCS）模型探索变量间的非线性关联。亚组分析按性别、年龄及受教育程度进行分层。
结果 本研究共回收1030份问卷，经质量控制后最终纳入1003份有效问卷。其中56.2%（564/1003）、53.2%（534/1003）及67.4%（676/1003）的受试者分别存在焦虑、抑郁及睡眠障碍。不同年龄、性别及受教育程度人群的基线特征存在显著统计学差异（P<0.05），亚组分析亦呈现相似的人口学特征趋势。单因素及多因素回归分析显示，年龄与焦虑（优势比OR=0.98，95%置信区间CI=0.97~0.99，P=0.02）、抑郁（OR=0.98，95%CI=0.96~0.99，P<0.001）呈负相关，而与睡眠障碍呈正相关（OR=1.03，95%CI=1.01~1.05，P<0.001）；男性群体罹患焦虑（OR=0.68，95%CI=0.52~0.88，P=0.004）与睡眠障碍（OR=0.72，95%CI=0.55~0.94，P=0.02）的风险更低；具备大学及以上学历的人群更易出现抑郁（OR=1.36，95%CI=1.04~1.77，P=0.02）与焦虑症状（OR=1.45，95%CI=1.11~1.89，P=0.007）。限制性立方样条（RCS）分析显示，不同人群中年龄与情感障碍间呈线性关联。
结论 年轻群体、女性及高学历人群的心理健康更易受影响，需对此类人群给予更多关注。