Health UK (Commonwealth Union) – A recent study uncovers a concerning link between non-alcoholic fatty liver disease (NAFLD) and an increased likelihood of individuals experiencing personality disorders when compared to those without this condition.
Furthermore, the research indicates that individuals with NAFLD, despite recognizing the importance of dietary and exercise interventions to manage their condition, often exhibit uncontrolled eating behaviors.
NAFLD has emerged as the predominant cause of chronic liver disease in affluent societies, contributing significantly to the growing number of liver-related fatalities.
Researchers pointed out that in the UK, as many as one in three individuals may be affected by fatty liver disease. While early-stage NAFLD may present few symptoms, the disease can advance to cirrhosis and liver failure, particularly in individuals at higher risk, such as those with diabetes.
Non-alcoholic steatohepatitis (NASH), a more severe variant of NAFLD characterized by liver inflammation, is the leading cause of cirrhosis in industrialized countries. Over the past five decades, liver disease-related mortality has surged fourfold in these regions.
Published in BMC Gastroenterology, the research conducted by the University of Birmingham reveals that individuals with NAFLD are approximately three times more likely to have a personality disorder compared to those without the disease.
The scientists advocate for the screening of NAFLD patients for personality disorders. If identified, these mental health disorders should be addressed prior to patients embarking on dietary and exercise interventions.
Co-author Dr Jonathan Catling, from the University of Birmingham, says “Finding an increased prevalence of personality disorders in NAFLD patients is particularly striking – signifying that it’s not an issue associated with all liver disease, but just those with NAFLD.
“Importantly, it appears not to be a general mental health issue, as neither anxiety nor depression were found to be significantly different between the groups – despite both psychiatric disorders often being associated with chronic liver disease.”
The researchers highlight that despite the well-established effectiveness of straightforward strategies such as dietary adjustments and increased physical activity in halting the progression of NAFLD, convincing patients to adhere to these programs can be challenging. This difficulty may be attributed to the advice often given to these patients, encouraging them to boost their protein and calorie intake in order to counteract the common nutritional declines associated with chronic liver disease.
Patients with NAFLD are cognizant of the positive outcomes associated with lifestyle modifications, but frequently encounter obstacles when attempting to implement these changes due to poor adherence. Even among patients who have undergone liver transplantation for NAFLD, a significant portion—two-fifths of them—exhibited signs of disease recurrence within five years following the transplantation procedure.
Dr Catling further said “Our findings suggest an urgent need to examine attitudes towards diet and exercise so that we can better understand how to motivate NAFLD patients and deliver more effective treatment – preventing disease recurrence after liver transplantation.”
A crucial determinant of a patient’s disposition toward weight loss is their internal and external “locus of control” (LoC), which refers to the extent to which they believe they can influence events in their life. Patients with a high internal LoC perceive life events as outcomes of their own actions and are more likely to achieve success in weight loss endeavors.
In the case of NAFLD patients, similar to individuals grappling with substance abuse disorders, they may exhibit a heightened external LoC, perceiving life events as beyond their control. Consequently, they encounter difficulties in initiating and sustaining the necessary dietary and exercise modifications crucial for preventing the progression of the disease into more severe and irreversible stages.
As of 2011, NAFLD was reported to affect up to 25% of the global adult population. This condition is characterized by metabolic disturbances, including the presence of lipid droplets in the liver, without the influence of excessive alcohol consumption, as indicated by researchers of the study.
