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Psychiatric Aspects of Liver Disease

Published online by Cambridge University Press:  02 January 2018

Ian Collis  and
Geoffrey Lloyd
Ian Collis*
Affiliation:
Academic Department of Psychiatry, Royal Free Hospital, Hampstead, London NW3 2QG
Geoffrey Lloyd
Affiliation:
Academic Department of Psychiatry, Royal Free Hospital, Hampstead, London NW3 2QG
*
∗Correspondence
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Extract

This paper reviews the literature on the effects of liver disease on mental health, a topic which has been relatively neglected in the recent psychiatric literature. It discusses both the encephalopathy which may be associated with liver disease of almost any type and the psychological consequences of specific liver disorders. Also considered are the effects of liver disease on sexual function; the relationship between alcohol and hepatic disorder in causing mental disturbance; the effects of childhood liver disease; psychiatric aspects of liver transplantation; and the use of psychotropic drugs in patients with hepatic dysfunction.

Type
Review Articles
Information
The British Journal of Psychiatry , Volume 161 , Issue 1 , July 1992 , pp. 12 - 22
Copyright
Copyright © 1992 The Royal College of Psychiatrists 

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References

Acker, W., Aps, E. J. & Majumdar, S. K. (1982) The relationship between brain and liver damage in chronic alcoholic patients. Journal of Neurology, Neurosurgery and Psychiatry, 45, 984–987.Google Scholar
Apstein, M. D., Koff, E. & Koff, R. S. (1979) Neuropsychological dysfunction in acute viral hepatitis. Digestion, 19, 349–358.Google Scholar
Arria, A. M., Tarter, R. E., Wartry, V., et al (1990) Vitamin E deficiency and psychomotor dysfunction in adults with primary biliary cirrhosis. American Journal of Clinical Nutrition, 52, 383–390.Google Scholar
Bach, N., Scaffner, F. & Kapelman, B. (1988) Sexual behaviour in women with nonalcoholic liver disease. Hepatology, 9, 698–703.Google Scholar
Balogssarini, R. J. & Fischer, J. E. (1977) Substitute and alternative transmitters in neuropsychiatric illness. Archives of General Psychiatry, 34, 958–964.Google Scholar
Beard, A. W. (1959) The association of hepatolenticular degeneration with schizophrenia. Acta Psychiatrica Neurologica Scandinavica, 34, 411–428.Google Scholar
Behan, P. O., Behan, W. M. & Bell, E. J. (1985) The postviral fatigue syndrome – an analysis of the findings in 50 cases. Journal of Infection, 10, 211–222.Google Scholar
Benjamin, P. Y., Levinsohn, M., Drotar, D., et al (1982) Intellectual and emotional sequelae of Reye's syndrome. Critical Care Medicine, 10, 583–587.Google Scholar
Bergeron, M., Layragues, G. P. & Butter worth, R. F. (1989) Aromatic and branched-chain amino acids in autopsied brain tissue from cirrhotic patients with hepatic encephalopathy. Metabolic Brain Disease, 4, 169–176.Google Scholar
Bergeron, M., Reader, T. A., Layragues, G. P., et al (1989) Monoamines and metabolites in autopsied brain tissue from cirrhotic patients with hepatic encephalopathy. Neurochemical Research, 14, 853–859.Google Scholar
Bernthal, P., Hays, A., Tarter, R. E., et al (1987) Cerebral CT scan abnormalities in cholestatic and hepatocellular disease and their relationship to neuropsychological test performance. Hepatology, 7, 107–114.Google Scholar
Bickford, R. G. & Butt, H. R. (1955) Hepatic coma: the electro-encephalographic pattern. Journal of Clinical Investigation, 34, 790–799.CrossRefGoogle Scholar
Bismuth, H. (1987) Liver transplantation: a subtle revolution. British Journal of Surgery, 74, 339–340.Google Scholar
Black, M. (1982) Hepatic detoxification of endogenously produced toxins and their importance for the pathogenesis of hepatic encephalopathy. In Hepatology. A Textbook of Liver Disease (eds Zakim, D. & Boyer, T.), pp. 397–414. Philadelphia: W. B. Saunders.Google Scholar
Branch, R. A. (1987) Is there increased sensitivity to benzodiazepines in chronic liver disease? Hepatology, 7, 773–776.CrossRefGoogle ScholarPubMed
Carvati, C. M. (1944) Posthepatitis syndrome. Southern Medical Journal, 37, 251–257.Google Scholar
Chadwick, J. & Mann, W. (1950) The Medical Works of Hippocrates: “The Sacred Disease”, p. 191. Oxford: Blackwell Scientific Publications Google Scholar
Cornely, C. M., Schade, R. R., van Thiel, D. H., et al (1984) Chronic advanced liver disease and impotence: cause and effect? Hepatology, 4, 1227–1230.Google Scholar
Davidson, E. A. & Summerskill, W. H. J. (1956) Psychiatric aspects of liver disease. Postgraduate Medical Journal, 32, 487–494.Google Scholar
Davidson, P. W., Willoughby, R. H., O'Tuama, L. A., et al (1978) Neurological and intellectual sequelae of Reye's syndrome. American Journal of Mental Deficiency, 82, 535–541.Google Scholar
Davison, K. & Bagley, C. R. (1969) Schizophrenia-like psychoses associated with organic disorders of the central nervous system: a review of the literature. In Current Problems of Neuropsychiatry (ed. Harrington, R. N.), British Journal of Psychiatry Special Publication No. 4. Ashford, Kent: Headley Brothers Google Scholar
Dell'Oro, A., Salvagni, M. & Naccarato, R. (1981) Problemes d'ordre psychologique chez les sujets porteurs de l'antigene Hbs. La Nouvelle Presse Medicate, 10, 256–257.Google Scholar
Dening, T. R. (1985) Psychiatric aspects of Wilson's disease. British Journal of Psychiatry, 147, 677–682.CrossRefGoogle ScholarPubMed
Dening, T. R. & Berrios, G. E. (1989) Wilson's disease: psychiatric symptoms in 195 cases. Archives of General Psychiatry, 46, 1126–1134.Google Scholar
Dening, T. R. & Berrios, G. E. (1989) Wilson's disease: a prospective study of psychopathology in 31 cases. British Journal of Psychiatry, 155, 206–213.Google Scholar
Dening, T. R. & Berrios, G. E. (1990) Wilson's disease: a longitudinal study of psychiatric symptoms. Biological Psychiatry, 28, 255–265.Google Scholar
Elithorn, A., Lanzer, M. & Weinmann, J. (1975) Cognitive deficits associated with chronic hepatic encephalopathy and their response to levodopa. Journal of Neurology, Neurosurgery and Psychiatry, 38, 794–798.Google Scholar
Elsass, P., Lund, Y. & Ranek, L. (1978) Encephalopathy in patients with cirrhosis of the liver, a neuropsychological study. Scandinavian Journal of Gastroenterology, 13, 241–247.Google Scholar
Ewusi-Mensah, I., Saunders, J. B., Wodak, A. D., et al (1983) Psychiatric morbidity in patients with alcoholic liver disease. British Medical Journal, 287, 1417–1419.Google Scholar
Farid, B. T., Johnson, R. D. & Lucas, E. G. (1988) Perception of illness among patients with alcoholic liver disease. Journal of Studies on Alcohol, 49, 375–377.Google Scholar
Foley, J., Watson, C. & Adams, R. (1950) Significance of dectroencephalographic changes in hepatic coma. Transactions of the American Neurological Association, 75, 161–165.Google Scholar
Fukudo, S., Suzuki, J., Tanaka, Y., et al (1989) The impact of stress on alcoholic liver injury: a histopathological study. Journal of Psychosomatic Research, 33, 515–521.Google Scholar
Gitlin, N., Lewis, D. C. & Hinkley, L. (1986) The diagnosis and prevalence of subclinical hepatic encephalopathy in apparently healthy ambulant non-shunted patients with cirrhosis. Journal of Hepatology, 3, 75–82.Google Scholar
Hall, R. C. W., Gardner, E. R. & Popkin, M. K. (1981) Unrecognized physical illness prompting psychiatric admissions: a prospective study. American Journal of Psychiatry, 138, 629–635.Google Scholar
Hall, R. C. W., Popkin, M. K., Devaul, R. A., et al (1978) Physical illness presenting as psychiatric disease. Archives of General Psychiatry, 35, 1315–1320.Google Scholar
Herridge, C. F. (1960) Physical disorders in psychiatric illness. Lancet, 2, 949–951.Google Scholar
Heyink, J. W., Tymstra, T., Sloof, M. J., et al (1990) Liver transplantation – psychosocial problems following the operation. Transplantation, 49, 1018–1019.Google Scholar
Johanssen, V., Andersson, T., Persson, A., et al (1989) Visual evoked potential – a tool in the diagnosis of encephalopathy? Journal of Hepatology, 9, 227–233.Google Scholar
Kiernan, T. W. & Powers, R. J. (1982) Hepatitis B virus in patients undergoing haemodialysis: transmission risks and psychosocial reactions. Archives of Internal Medicine, 142, 51–54.Google Scholar
Kober, B., Kuchler, T., Broelsch, C., et al (1990) A psychological support concept and quality of life research in a liver transplant program: an interdisciplinary multicentre study. Psychotherapy and Psychosomatics, 54, 117–131.Google Scholar
Kumar, S., Basista, M., Stauber, R. E., et al (1989) Orthoptic liver transplantation for alcoholic liver disease. Gastroenterology, 96, A916.Google Scholar
Kwantes, N., Vindreau, C., Samuel, D., et al (1990) Modifications neuropsychologique et complications psychiatriques observées dans une population de transplantés hépatiques. Annales Médico-psychologiques, 148, 97–104.Google Scholar
Lee, K., Moller, L., Hardt, F., et al (1979) Alcohol-induced brain damage and liver damage in young males. Lancet, 2, 759–761.Google Scholar
Leipzig, R. M. (1990) Psychopharmacology in patients with hepatic and gastrointestinal disease. International Journal of Psychiatry in Medicine, 20, 109–139.Google Scholar
Lok, A. S., van Leevwen, D. J., Thomas, H. C., et al (1985) Psychosocial impact of chronic infection in patients with hepatitis B virus on British in-patients. Genito-urinary Medicine, 61, 279–282.Google Scholar
Lowe, D., O'Grady, J. C., McEwen, J., et al (1990) Quality of life following liver transplantation: a preliminary report. Journal of the Royal College of Physicians of London, 24, 43–46.Google Scholar
McDonald, E. M., Mann, A. H. & Thomas, H. C. (1987) Interferons as mediators of psychiatric morbidity. An investigation in a trial of recombinant alpha-interferon in hepatitis B carriers. Lancet, 2, 1175–1178.Google Scholar
Maguire, G. P. & Granville Grossman, K. L. (1968) Physical illness in psychiatric patients. British Journal of Psychiatry, 114, 1365–1369.Google Scholar
Maguire, G. P., Julier, D. L., Hawton, K. E., et al (1974) Psychiatric morbidity and referral on two general medical wards. British Medical Journal, i, 268–270.Google Scholar
Manz, H. J. & Colon, A. R. (1982) Neuropathology, pathogenesis and neuropsychiatric sequelae of Reye syndrome. Journal of the Neurological Sciences, 53, 377–395.Google Scholar
Marshall, H. E. S. (1949) Incidence of physical disorders amongst psychiatric in-patients. A study in 175 cases. British Medical Journal, 2, 468–470.Google Scholar
Martini, G. A. & Strohmeyer, G. (1974) Posthepatitis syndromes. Clinics in Gastroenterology, 3, 377–390.Google Scholar
Msdalia, A., Isaacs-Glaberman, K. & Scheinberg, I. H. (1988) Neuropsychological impairment in Wilson's disease. Archives of Neurology, 45, 502–504.CrossRefGoogle Scholar
Medalia, A. & Scheinberg, I. H. (1989) Psychopathology in patients with Wilson's disease. American Journal of Psychiatry, 146, 662–674.Google Scholar
Moore, J. W., Dunk, A. A., Crawford, J. R., et al (1989) Neuropsychological deficits and MRI brain scan abnormalities in apparently healthy non-encephalopathic patients with cirrhosis: a controlled study. Journal of Hepatology, 9, 319–325.Google Scholar
Morgan, M. Y., Alonso, M. & Stanger, L. C. (1989) Lactitol and lactulose for the treatment of subclinical hepatic encephalopathy in cirrhotic patients. A randomized cross-over study. Journal of Hepatology, 8, 208–217.Google Scholar
Murphy, T. L., Chalmers, T. C., Eckhardt, R. D., et al (1948) Hepatic coma. Clinical and laboratory observations on forty patients. New England Journal of Medicine, 239, 605–608.Google Scholar
Nesbitt, J. A. & Minuk, G. Y. (1988) Adult Reye's syndrome. Annals of Emergency Medicine, 17, 155–158.Google Scholar
Neuberger, J. M. (1989) Transplantation for alcoholic liver disease. British Medical Journal, 299, 693–694.Google Scholar
Olomu, A. B., Vickers, C. F., Waring, R. H., et al (1981) High incidence of poor sulfoxidation in patients with primary biliary cirrhosis. New England Journal of Medicine, 318, 1089–1092.Google Scholar
Parsons-Smith, B. G., Summerskill, W. H. J., Dawson, A. M., et al (1957) The electroencephalograph in liver disease. Lancet, 2, 867–871.Google Scholar
Patek, A. J. Jnr. & Hermos, J. A. (1981) Recovery from alcoholism in cirrhotic patients: a study of 45 cases. American Journal of Medicine, 70, 783–785.Google Scholar
Phillips, R. J. (1937) Physical disorder in 164 consecutive admissions to a mental hospital. The incidence and significance. British Medical Journal, 2, 363–366.CrossRefGoogle Scholar
Powell, E. E., Pender, M. P., Chalk, J. B., et al (1990) Improvement in chronic hepatocerebral degeneration following liver transplantation. Gastroenterology, 98, 1079–1082.Google Scholar
Puca, F. M., Antonaci, F., Panella, C., et al (1989) Psychomotor dysfunctions in alcoholic and postnecrotic cirrhotic patients without overt encephalopathy. Acta Neurologica Scandanavica, 79, 280–287.Google Scholar
Quart, E. J., Buchter, H. A. & Sarnaik, A. P. (1988) Long-lasting memory deficits in children recovered from Reye's syndrome. Journal of Clinical and Experimental Neuropsychology, 10, 409–420.Google Scholar
Read, A. E., Sherlock, S., Laidlaw, J., et al (1967) The neuropsychiatric syndromes associated with chronic liver disease and an extensive portal-systemic circulation. Quarterly Journal of Medicine, 36, 135–150.Google Scholar
Rehnstrom, S., Simert, G., Hansson, J. A., et al (1977) Chronic hepatic encephalopathy: a psychometrical study. Scandinavian Journal of Gastroenterology, 12, 305–311.Google Scholar
Rikkers, L., Jenko, P., Rudman, O., et al (1978) Subclinical hepatic encephalopathy: detection, prevalence, and relationship to nitrogen metabolism. Gastroenterology, 75, 462–469.Google Scholar
Ron, M. A. (1983) The Alcoholic Brain: CT Scan and Psychological Findings. Psychological Medicine, Monograph Supplement 3. Cambridge: Cambridge University Press Google Scholar
Sarin, S. K., Sachdev, G., Jildha, R. C., et al (1988) Pattern of psychiatric morbidity and alcohol dependence in patients with alcoholic liver disease. Digestive Diseases and Sciences, 33, 443–448.Google Scholar
Saunders, J. B. (1983) Alcoholic liver disease in the 1980s. British Medical Journal, 287, 1819–1821.Google Scholar
Saunders, J. B., Walters, J. R. F., Davies, P., et al (1981) A 20 year prospective study of cirrhosis. British Medical Journal, 282, 263–266.Google Scholar
Scheinberg, I. H. & Sternlieb, I. (1984) Wilson's disease. In Major Problems in Internal Medicine, Vol. 23. Philadelphia: W. B. Saunders Google Scholar
Sherlock, S. (1989) Diseases of the Liver and Biliary System (eighth edition), pp. 95–115. Oxford: Blackwell Scientific Publications Google Scholar
Sherlock, S., Summerskill, W. H. J., White, L. P., et al (1954) Portal-systemic encephalopathy. Neurological complications of liver disease. Lancet, 2, 453–457.Google Scholar
Sherlock, S. & Walshe, J. M. (1946) The post-hepatitis syndrome. Lancet, 2, 482–484.Google Scholar
Sood, G. K., Sarin, S. K., Mahaptra, J., et al (1989) Comparative efficacy of psychometric tests in the detection of subclinical hepatic encephalopathy in non-alcoholic cirrhotics: search for a rational approach. American Journal of Gastroenterology, 84, 156–159.Google Scholar
Stewart, S. M., Uauy, R., Waller, D. A., et al (1987) Mental and motor development correlates in patients with end-stage biliary stresia awaiting liver transplantations. Pediatrics, 79, 882–888.Google Scholar
Stewart, S. M., Uauy, R., Kennard, B. D., et al (1988) Mental development and growth in children with chronic liver disease of early and late onset. Pediatrics, 82, 167–172.Google Scholar
Stewart, S. M., Uauy, R. & Waller, D. A. (1989) Mental and motor development, social competence, and growth one year after successful pediatric liver transplantation. Journal of Pediatrics, 114, 574–581.Google Scholar
Summerskill, W. H. J., Davidson, E. A., Sherlock, S., et al (1956) The neuropsychiatric syndrome associated with chronic liver disease and an extensive portal-systemic collateral circulation. Quarterly Journal of Medicine, 25, 245–266.Google Scholar
Surman, O. S. (1989) Psychiatric aspects of organ transplantation. American Journal of Psychiatry, 146, 972–982.Google Scholar
Surman, O. S., Dienstag, J. L., Cosimi, A. B., et al (1987) Psychosomatic aspects of liver transplantation. Psychotherapy and Psychosomatics, 48, 26–31.Google Scholar
Tarter, R. E., Heoedus, A., van Thiel, D. H., et al (1984) Nonalcoholic cirrhosis associated with neuropsychological dysfunction in the absence of overt evidence of encephalopathy. Gastroenterology, 86, 1421–1427.Google Scholar
Tarter, R. E., Heoedus, A., van Thiel, D. H., et al (1986) Hepatic dysfunction and neuropsychological test performance in alcoholics with cirrhosis. Journal of Studies on Alcohol, 47, 74–77.Google Scholar
Tarter, R. E., Hays, A. L., Sandford, S. S., et al (1986) Cerebral morphological abnormalities associated with nonalcoholic cirrhosis. Lancet, 2, 893–895.Google Scholar
Tarter, R. E., Carra, J., Switala, J., et al (1987) Sequential concept formation capacity in subclinical (latent) portal-systemic encephalopathy. International Journal of Neuroscience, 32, 891–894.Google Scholar
Tarter, R. E., Switala, J. A., Carra, J., et al (1987) Neuropsychiatric impairment associated with hepatolenticular degeneration (Wilson's disease) in the absence of overt encephalopathy. International Journal of Neuroscience, 37, 67–71.Google Scholar
Tarter, R. E., van Thiel, D. H., Arria, A. M., et al (1988) Impact of cirrhosis on neuropsychological test performance of alcoholics. Alcoholism, 12, 619–621.Google Scholar
Tarter, R. E., Erb, S., Biller, P. A., et al (1988) Quality of life following liver transplantations: a preliminary report. Gastroenterology Clinics of North America, 17, 207–217.Google Scholar
Tarter, R. E., Sandford, S. L. & Hays, A. L. (1989) Hepatic injury correlates with neuropsychological impairment. International Journal of Neuroscience, 44, 75–82.Google Scholar
Tarter, R. E., Switala, J. A., Arria, A., et al (1990) Subclinical hepatic encephalopathy: comparison before and after orthoptic liver transplantation. Transplantation, 50, 632–637.Google Scholar
Trzepacz, P. T., Brenner, R. & van Thiel, D. H. (1989) A psychiatric study of 247 liver transplantation candidates. Psychosomatics, 30, 147–153.Google Scholar
Van Thiel, D. H., Gavaler, J. S., Spero, J. A., et al (1981) Patterns of hypothalamic–pituitary–gonadal dysfunction in men with liver disease due to differing etiologies. Hepatology, 1, 39–46.Google Scholar
Victor, M., Adams, R. D. & Cole, M. (1965) The acquired (non-Wibonian) type of chronic hepatocerebral degeneration. Medicine, 44, 345–396.Google Scholar
Walshe, J. M. (1951) Observations on the symptomatology and pathogenesis of hepatic coma. Quarterly Journal of Medicine, 20, 421–431.Google Scholar
Weissenborn, K., Scholz, M., Hinrichs, H., et al (1990) Neurophysiological assessment of early hepatic encephalopathy. Electroencephalography and Clinical Neurophysiology, 75, 289–295.Google Scholar
Weissman, M. M., Myers, J. K. & Harding, P. S. (1977) Prevalence and psychiatric heterogenecity of alcoholism in the United States urban community. Journal of Studies on Alcohol, 41, 672–681.Google Scholar
White, L. P., Phear, E. A., Summerskill, W. H. J., et al (1955) Ammonium tolerance in liver disease: observations based on catheterisation of the hepatic veins. Journal of Clinical Investigation, 34, 158–168.Google Scholar
Williams, F. J. B. & Walshe, J. M. (1981) Wilson's disease: an analysis of the cranial computerized tomographic appearances found in 60 patients and the changes in response to chelating agents. Brain, 104, 735–752.Google Scholar
Wilson, S. A. K. (1912) Progressive lenticular degeneration: a familial nervous disease associated with cirrhosis of the liver. Brain, 34, 295–507.Google Scholar
Wodak, A. D., Saunders, J. B., Ewusi-Mensah, I., et al (1983) Severity of alcohol dependence in patients with alcoholic liver disease. British Medical Journal, 287, 1420–1422.Google Scholar
Zeneroli, M. L., Pinelli, G., Gollini, G., et al (1984) Visual evoked potential: a diagnostic tool for the assessment of hepatic encephalopathy. Gut, 25, 291–299.Google Scholar
Zeneroli, M. L., Cioni, C., Vezzelli, C., et al (1987) Prevalence of brain atrophy in liver cirrhosis patients with chronic persistent encephalopathy. Evaluation by computed tomography. Journal of Hepatology, 4, 283–292.Google Scholar
Zieve, L. (1987) Hepatic encephalopathy. In Diseases of the Liver (sixth edition) (eds Schiff, L. & Schiff, E. R.), pp. 925–948. Philadelphia: J. B. Lippincott Google Scholar
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