ORIGINAL RESEARCH article
Front. Public Health
Sec. Aging and Public Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1584211
This article is part of the Research TopicMental Health Challenges in Long-term Pharmacotherapy for Patients with Chronic DiseasesView all 12 articles
Quantifying depression and the risk of chronic liver diseases: results from a large-scale longitudinal cohort study
Provisionally accepted
- 1Zibo Central Hospital, Shandong, China
- 2Shandong Daizhuang Hospital, Jining, Shandong Province, China
- 3Shengjing Hospital of China Medical University, Shenyang, China
- 4West China School of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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Background: Chronic liver diseases and depression are both major public health concerns worldwide, particularly among aging populations. However, evidence on the prospective association between depressive symptoms and the risk of developing chronic liver diseases remains limited. The aim of this study is to explore the potential association in middle-aged and older Chinese adults.Methods: Data for this study were obtained from the China Health and Retirement Longitudinal Study (CHARLS), and 11,272 participants without prior liver disease were finally included in this study. Depression was assessed using the CESD-10, with scores analyzed as continuous variables and chronic liver diseases were self-reported based on physician diagnosis. Chronic liver diseases were self-reported based on physician diagnoses. By adjusting for multiple covariates, Cox proportional hazards regression models were used to estimate hazard ratios and restricted cubic spline models were applied to assess the potential non-linear relationships.Findings: Over a mean follow-up period of 6.85 years, a total of 570 participants were finally diagnosed with chronic liver diseases. Multivariate regression analyses revealed a significant association between CESD scores and the risk of liver diseases among study participants even accounting for all potential covariates (HR: 1.020, 95% CI: 1.006-1.033, P = 0.004). Restricted cubic spline models further revealed an S-shaped relationship between CESD score and liver diseases (p for overall < 0.013), suggesting the possible potential non-linear trends in the association.We identified a significant, nonlinear association between depressive symptoms and subsequent development of chronic liver diseases. Based on observational findings, depressive symptoms may represent a potential early marker of liver disease risk. These findings highlight the importance of integrating mental health assessments into early routine clinical care.
Keywords: Chronic Liver Diseases, Depression, Elderly, CHARLS, Risk factors
Received: 27 Feb 2025; Accepted: 01 Sep 2025.
Copyright: © 2025 Wang, Zhao, Wang and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Hailiang Wang, Zibo Central Hospital, Shandong, China
Xiaoyang Liu, West China School of Medicine, West China Hospital, Sichuan University, Chengdu, 610000, Sichuan Province, China
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