Poor Coping Negatively Affects Vitality, Mental Health, Role-Physical in NAFLD

Poor vitality and mental health along with the presence of type 2 diabetes (T2D), obesity, and significant liver fibrosis are associated with depressive symptoms or poorer self-efficacy in patients with nonalcoholic fatty liver disease (NAFLD), according to a study published in Journal of Psychosomatic Research.

In this cross-sectional study, researchers examined depressive symptoms, self-efficacy, active coping, passive/avoidant coping, vitality, mental health, role-physical, and body mass index (BMI) in patients with biopsy-proven NAFLD (N=509). For the analysis, researchers used the Beck Depression Inventory-II, the General Self-Efficacy Scale, the Brief COPE, and the 12-Item Short Form Health Survey.

Patients with T2D had significantly worse depressive symptoms (P <.001) and less active coping (P =.014) and vitality (P <.001). Active coping, vitality, T2D, and BMI were significantly associated with depressive symptoms; vitality partially mediated the relationship between active coping and depressive symptoms. Passive/avoidant coping, mental health, role-physical, and significant fibrosis were significantly associated with self-efficacy.

Study limitations include using a cross-sectional design, which impeded the ability to determine causal relationships and long-term outcomes. These findings may also not be generalizable to patients with other liver or metabolic diseases, as the study included only patients with NAFLD.

“These results highlight the need for a multidisciplinary NAFLD intervention model, including psychologists, who can implement cognitive-behavioral intervention techniques,” the study authors concluded. “Patients would benefit from such intervention by overcoming risk factors associated with decline of their vitality and more depressive symptoms. … Cognitive-behavioral intervention techniques, which have previously shown positive results with patients with chronic metabolic diseases, would help promote greater perception of the controllability of their disease.”