Table5_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.

研究背景 慢性肝病（Chronic Liver Disease, CLD）患者的心理健康状况亟待更深入的关注与认知，尤其是针对其相关危险因素的探究。
研究方法 本研究连续纳入本院肝病门诊的慢性肝病患者，所有受试者均完成问卷调查，分别采用广泛性焦虑障碍7项量表（GAD-7）、患者健康问卷9项量表（PHQ-9）及匹兹堡睡眠质量指数（PSQI）评估其焦虑、抑郁状况与睡眠质量。采用克朗巴哈α系数（Cronbach’s α）与凯泽-迈耶-奥尔金检验（Kaiser-Meyer-Olkin, KMO）评估量表的信度与效度；针对连续变量与分类变量，分别采用曼-惠特尼U检验与卡方检验进行分析。采用单因素与多因素logistic回归分析识别危险因素，同时运用限制性立方样条（RCS）探索变量间的非线性关联。按性别、年龄及受教育程度进行亚组分析。
研究结果 本研究共回收1030份问卷，经质量控制后纳入有效问卷1003份。其中分别有56.2%（564/1003）、53.2%（534/1003）及67.4%（676/1003）的受试者存在焦虑、抑郁及睡眠障碍。不同年龄、性别与受教育程度的受试者间基线特征存在显著差异（P<0.05），亚组分析亦呈现相似的人口学趋势。单因素与多因素回归分析结果显示：年龄与焦虑（比值比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）；男性相较于女性更不易出现焦虑（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）；拥有大学及以上学历的人群更易罹患抑郁（OR=1.36，95%CI=1.04~1.77，P=0.02）与焦虑（OR=1.45，95%CI=1.11~1.89，P=0.007）。限制性立方样条分析结果提示，不同人群中年龄与情感障碍之间呈线性关联。
研究结论 青年群体、女性及受教育程度较高人群的心理健康更易受损，亟待获得更多关注。