The liver and psychiatry

Liver disease is very common in the population. The disease has many varieties. To the question whether we have enough knowledge on this subject, I can unfortunately not give a positive reply. Liver disease has a cultural aspect in that it is commonly associated with a risk of infection. Alcohol consumption plays an important role in liver disease. People with damaged livers experience mood problems, as do people who had an organ transplant. Rejection of a transplanted organ is also a common situation.

Prof. Dr. Kemal Arıkan answered the questions of Hürriyet reporter Uğur İlyas CANPOLAT on the subject.

– Could you please first of all explain to us the role of the liver in the body? What is its function?

The liver is the body’s factory. It plays an important role in the metabolism of fat, sugar, proteins and other substances. It also acts as a refinery.

– Can we talk about masking? Does it progress insidiously or are there cases in which the disease appears suddenly?

Liver disease usually progresses insidiously. However fulminant hepatitis can set in all over sudden.

– Is it correct that it is more common in people with major depression.

Liver diseases can lead to a variety of psychiatric disorders. One of them is major depression.

– Can you explain to us the link between liver disease which is a physical illness, and psychiatry?

They are closely linked. As liver disease affects the concentration of various neurotransmitters in the brain, it can mimic any kind of psychiatric picture.

– Are there similarities in symptoms? What catches the attention of the doctor?

If there are no organic findings, liver disease can escape the attention of the doctor.

– What do you think about the impact of excessive alcohol consumption on liver disease?

These are closely linked. Through various mechanisms alcohol exercises a toxic effect on the liver.

– Does excessive drug use also have an impact on this disease?

Ill-informed and irresponsible drug use can unfortunately cause liver disease.

– Do Hepatitis B and C trigger psychiatric disorders?

Yes.

– What are the most common psychiatric pictures in liver disease?

Depression, mania, dementia, delirium, psychosis.

– Under which disciplines should a patient be treated who has both liver disease and a psychiatric condition?

The patient should of course be followed up both by a hepatologist and a psychiatrist.

– How does a damaged organ affect the patient’s psychological state?

It leads to the patient to feel deficient. The Self is damaged.

– What changes can be seen in the behaviour of a person with liver disease? Is it noticeable from the outside?

Mood changes throughout the day, forgetfulness, inattention and personality changes are amongst the main signs.

– Does liver disease affect male and female hormones?

Yes.

– How does this establish itself ?

The disturbance in the hormonal processes can lead to psychiatric disturbances, symptoms depend on whether there is a lack or excess of a particular hormone. Irritability is a symptom shared by all.

– Do we see neurological symptoms as well as psychiatric symptoms in patients with liver disease?

Yes. Tremor, asterixis and similar neurological symptoms.

– What is your opinion on liver transplants?

As long as ethical principles are followed it is a useful practice. I support it.

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