ArticleGastro hep advances2026
Comorbid Depression Among US Adults With Elastography-Defined Advanced Chronic Liver Disease and Clinically Significant Portal Hypertension: National Health and Nutrition Examination Survey 2017-2023.
Article in Gastro hep advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and Aims: Depression is a critical yet underrecognized comorbidity in chronic liver disease, with important implications for treatment adherence, self-management, and clinical outcomes. However, nationally representative estimates of comorbid depression using contemporary elastography-defined advanced chronic liver disease (ACLD) and clinically significant portal hypertension (CSPH) are lacking. Methods: We analyzed adults from the National Health and Nutrition Examination Survey 2017-2020 and 2021-2023 cycles using valid vibration-controlled transient elastography, Patient Health Questionnaire-9 data, and complete covariates. Survey-weighted logistic regression identified factors associated with depression in ACLD patients, adjusting for the identified covariates. Sensitivity analyses were used to evaluate alternative Patient Health Questionnaire-9 scoring assumptions. Results: Among 13,291 participants representing the US adult population, the weighted prevalence of comorbid depression was 12.16% with 95% confidence interval (CI) 8.65, 15.66%. In multivariate analysis, female sex (adjusted odds ratio [aOR] 3.51; 95% CI 1.98, 6.23; Conclusion: Approximately 12% to 13% of US adults with ACLD or CSPH experience comorbid depression, with an increase in the post-COVID-19 era. Depression burden was the highest among women, younger adults, individuals with high sedentary time, and non-Hispanic Black adults with CSPH. Therefore, there is a need to integrate behavioral health pathways into hepatology care.
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