Psychological factors associated with NAFLD/NASH: a systematic review

Area of Science:

• Hepatology
• Psychology
• Internal Medicine

Background:

• Nonalcoholic fatty liver disease (NAFLD) is a prevalent chronic liver condition globally.
• The exact pathogenesis of NAFLD and its severe form, nonalcoholic steatohepatitis (NASH), remains incompletely understood.
• Numerous potential causal mechanisms are under investigation.

Purpose of the Study:

• To review the psychological factors associated with NAFLD/NASH.
• To identify emotional, cognitive, and behavioral contributors to NAFLD/NASH development and progression.

Main Methods:

• A systematic literature search was conducted across five major electronic databases (PubMed, Web of Science, Scopus, ProQuest, ScienceDirect).
• Studies published in English between 2005 and 2015 were included.
• The review focused on emotional, cognitive, and behavioral factors.

Main Results:

• Depression and anxiety were identified as significant emotional factors.
• Cognitive functioning related to initiating and sustaining lifestyle changes was a key area of investigation.
• Physical activity, nutrition, and substance use (coffee, alcohol, cigarettes) emerged as critical behavioral factors.

Conclusions:

• Identified psychological factors can act as either protective or vulnerability factors in NAFLD/NASH.
• NAFLD/NASH can be conceptualized as a cognitive-behavioral disease.
• Effective management strategies emphasize lifestyle modifications, particularly diet and exercise.