Quality of life in cirrhotics with minimal hepatic encephalopathy

Minimal hepatic encephalopathy (HE) is a major cause of premature retirement in cirrhotics. The decision on the earning capability of a patient is usually based on clinical judgement, considering the patient's complaints and clinical findings such as nervousness and depression. In a comprehensive psychometric study we were able to show that cirrhotic patients, who are considered to be unable to earn their living, differ significantly from those who are working, in tests evaluating psychomotor function and in personality and subjective well-being scores representing nervousness, aggressiveness, depression. The latter scores are considered to represent the individual discrepancies between professional demands and cerebral performance. Since minimal HE affects psychomotor function but not verbal abilities this discrepancy exists predominantly in "blue collar workers." In accordance with this 60% of "blue collar" (in contrast to 20% of "white collar") workers of our patient group were considered unfit for work. Working ability is an essential element of quality of life in Western societies. Thus, an impairment of working capability is of major impact on quality of life in cirrhotics.