Patients with a common form of liver disease are three times more likely to suffer with a personality disorder than people without the condition, according to a study.
Researchers from the University of Birmingham found that sufferers of non-alcoholic fatty liver disease (NAFLD) were at increased risk of developing serious mental health issues.
Up to one in three people in the UK has fatty liver disease. While in its early stages there may be few symptoms, the disease can progress to cirrhosis and liver failure in at risk individuals such as diabetics.
NAFLD has become the most common cause of chronic liver disease in wealthy societies. The main risk factors include obesity, insulin resistance and heavy alcohol use.
The disease must be managed through a strict diet and exercise, but researchers said that personality disorders can frequently cause patients to exhibit uncontrolled eating behaviours.
There are several different types of personality disorder, including borderline personality disorder and narcissistic personality disorder. Symptoms vary with each condition but they tend to cause fundamental changes in thinking, feeling and behaviour.
Co-author Dr Jonathan Catling, from the University of Birmingham, said: “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 involved in the study have called for NAFLD patients to be screened for personality disorders. If identified, these disorders should be treated before the patients begin trying to control their diet and exercise more.
One factor determining a patient’s attitudes towards weight loss is their internal and external “locus of control”, which is the amount of control they believe they have over their life events.
Patients with a high internal LoC perceive life events to be a result of their own actions and are more likely to be successful in losing weight.
The researchers said that individuals with NAFLD may have a high external LoC, which means that they see life events as out of their control.
This means they can struggle to make and maintain the necessary changes to their diet and exercise regime that prevent NAFLD from progressing into a serious, irreversible disease.
Dr Catling added: “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.”
