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The bidirectional association of nonalcoholic fatty liver disease with depression, bipolar disorder, and schizophrenia

Published online by Cambridge University Press:  21 October 2022

Muhammad Youshay Jawad ,
Shakila Meshkat ,
Aniqa Tabassum ,
Andrea Mckenzie ,
Joshua D. Di Vincenzo ,
Ziji Guo ,
Nabiha Batool Musavi ,
Lee Phan ,
Felicia Ceban  and
Angela TH Kwan
...Show all authors
Muhammad Youshay Jawad
Affiliation:
Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada Brain and Cognition Discovery Foundation, Toronto, ON, Canada
Shakila Meshkat
Affiliation:
Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
Aniqa Tabassum
Affiliation:
Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
Andrea Mckenzie
Affiliation:
Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
Joshua D. Di Vincenzo
Affiliation:
Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
Ziji Guo
Affiliation:
Brain and Cognition Discovery Foundation, Toronto, ON, Canada
Nabiha Batool Musavi
Affiliation:
Liaquat National Medical College, Karachi, Pakistan
Lee Phan
Affiliation:
Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
Felicia Ceban
Affiliation:
Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada Brain and Cognition Discovery Foundation, Toronto, ON, Canada
Angela TH Kwan
Affiliation:
Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada Brain and Cognition Discovery Foundation, Toronto, ON, Canada Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
Ranuk Ramachandra
Affiliation:
Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada Brain and Cognition Discovery Foundation, Toronto, ON, Canada
Gia Han Le
Affiliation:
Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada Brain and Cognition Discovery Foundation, Toronto, ON, Canada
Rodrigo B. Mansur
Affiliation:
Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada Department of Psychiatry, University of Toronto, Toronto, ON, Canada
Joshua D. Rosenblat
Affiliation:
Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada Department of Psychiatry, University of Toronto, Toronto, ON, Canada
Roger Ho
Affiliation:
Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
Taeho Greg Rhee
Affiliation:
Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA VA New England Mental Illness, Research, Education and Clinical Center (MIRECC), VA Connecticut Healthcare System, West Haven, CT, USA Department of Public Health Sciences, School of Medicine, University of Connecticut, Farmington, CT, USA
Roger S. McIntyre*
Affiliation:
Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada Brain and Cognition Discovery Foundation, Toronto, ON, Canada Department of Psychiatry, University of Toronto, Toronto, ON, Canada Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
*
*Author for correspondence: Roger S. McIntyre Email: [email protected]
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Abstract

Nonalcoholic fatty liver disease (NAFLD) is a complex metabolic-inflammatory disease associated with poor outcomes and decreased quality of life. NAFLD is overrepresented in patients with psychiatric disorders like depression, bipolar disorder, and schizophrenia; however, a comprehensive review on NAFLD and psychiatric disorders remains to be delineated. This review endeavors to investigate the association of NAFLD with psychiatric disorders, including shared pathogenesis and future clinical derivatives. Extant literature suggests that patients with psychiatric disorders (in particular, mood disorders) are more susceptible to the development of NAFLD due to multiple reasons, including but not limited to hypothalamic–pituitary–adrenal axis dysregulation, metabolic syndrome, and chronic perceived stress. Moreover, the clinical manifestations of mood disorders (e.g., anhedonia, psychomotor retardation, lifestyle modification, etc.), and potentially long-term treatment with weight-gaining agents, differentially affect these patients, making them more prone to NAFLD. Considering the increased morbidity associated with both mood disorders and NAFLD, our review recommends regular screenings for NAFLD in select patients with mood disorders exhibiting signs of increased risk (i.e., obesity, metabolic syndrome, diabetes, or family history of NAFLD) for better diagnosis and holistic care of both potentially interrelated conditions.

Keywords

DepressionBipolar disorderMood DisordersSchizophreniaNAFLDNASHFatty LiverMetabolic SyndromeInflammationinsulin resistance
Type
Review
Information
CNS Spectrums , Volume 28 , Issue 5 , October 2023 , pp. 541 - 560
Copyright
© The Author(s), 2022. Published by Cambridge University Press

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