Effect of Post-Traumatic Stress Disorder on Cognitive Function and Covert Hepatic Encephalopathy Diagnosis in Cirrhotic Veterans
| Autor: | Andrew Fagan, Michael Fuchs, Douglas M. Heuman, Michael S. Ellwood, Jasmohan S Bajaj, Thomas K. Burroughs, James B. Wade |
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| Rok vydání: | 2017 |
| Předmět: |
Liver Cirrhosis
Male Alcoholic liver disease medicine.medical_specialty Cirrhosis Physiology behavioral disciplines and activities Article Stress Disorders Post-Traumatic 03 medical and health sciences 0302 clinical medicine Cognition Risk Factors Internal medicine parasitic diseases mental disorders medicine Humans Effects of sleep deprivation on cognitive performance Hepatic encephalopathy Aged Veterans Psychomotor learning integumentary system business.industry Gastroenterology Traumatic stress Middle Aged medicine.disease Substance abuse Logistic Models Hepatic Encephalopathy Multivariate Analysis Etiology 030211 gastroenterology & hepatology Female business 030217 neurology & neurosurgery |
| Zdroj: | Digestive diseases and sciences. 63(2) |
| ISSN: | 1573-2568 |
| Popis: | In veterans, post-traumatic stress disorder (PTSD) is often associated with substance abuse, which in turn can lead to cirrhosis. Cirrhotic patients are prone to cognitive impairment, which is typically due to covert hepatic encephalopathy (CHE), but can also be affected by PTSD. The aim was to define the impact of PTSD on cognitive performance and the diagnosis of CHE in cirrhotic patients. Outpatient veterans with cirrhosis underwent two separate modalities for CHE cognitive testing [Psychometric Hepatic Encephalopathy Scale (PHES) and Inhibitory Control Test (ICT)]. ICT tests for inhibitory control and response inhibition, while PHES tests for attention and psychomotor speed. Comparisons were made between patients with/without PTSD. Multivariable logistic regression with CHE on PHES and CHE on ICT as dependent variables including prior OHE, demographics, PTSD and psychotropic medications was performed. Of 402 patients with cirrhosis, 88 had evidence of PTSD. Fifty-five of these were on psychoactive medications, 15 were undergoing psychotherapy, while no specific PTSD-related therapy was found in 28 patients. Cirrhotic patients with/without PTSD were statistically similar on demographics and cirrhosis severity, but cirrhotic subjects with PTSD had a higher frequency of alcoholic cirrhosis etiology and psychotropic drug use. PTSD cirrhosis had higher ICT lure and switching errors (NCT-B response), but on regression, there was no significant impact of PTSD on CHE diagnosis using either the ICT or PHES. Veterans with cirrhosis and PTSD have a higher frequency of psychotropic drug use and alcoholic cirrhosis etiology. CHE diagnosis using PHES or ICT is not affected by concomitant PTSD. |
| Databáze: | OpenAIRE |
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