[Title]
The prognostic impact of psychiatric intervention on alcohol-associated liver disease : the UK Biobank cohort study

[Author]
Keungmo Yang¹, Sunghwan Kim^2,3, Hyun Yang¹, Sheng-Min Wang², Bumseok Jeong³, Hyun Kook Lim², Si Hyun Bae<sup>1

1</sup>Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
²Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Republic of Korea
³Graduate School of Medical Science and Engineering, Korea Advanced Institute for Science and Technology (KAIST), Daejeon 34141, Republic of Korea

* Correspondence
  Bumseok Jeong , Tel: +82-42-350-4525, Fax: +42-350-7160, Email: bs.jeong@kaist.ac.kr
  Hyun Kook Lim , Tel: +82-2-3779-1048, Fax: +82-2-780-6577, Email: drblues@catholic.ac.kr
  Si Hyun Bae , Tel: +82-2-2258-6020, Fax: +82-2-3481-4025, Email: baesh@catholic.ac.kr

[Journal] 
 Clinical and Molecular Hepatology, August 26, 2024. DOI: https://doi.org/10.3350/cmh.2024.0278


[Abstract]

Background/Aims
Alcohol-associated liver disease (ALD) is a public health concern. ALD patients often have psychiatric comorbidities, but the effects of psychiatric interventions on ALD are not well-established. This study explores the prognostic impact of psychiatric intervention on ALD within UK Biobank cohort.
Methods
This population-based study included 2,417 ALD patients from the UK Biobank cohort. Psychiatric intervention was defined by a consultation with psychiatrists during hospitalization or a history of medication related to alcohol use disorder and psychiatric comorbidities. Survival analysis was conducted, incorporating propensity score matching (PSM), to precisely assess the impact of psychiatric intervention.
Results
Among 2,417 ALD patients, those with F10 (mental disorders due to alcohol) codes had poorer survival outcomes. Psychiatric intervention significantly improved the outcomes of both all-cause and liver-related mortality and reduced the incidence of liver cirrhosis. In subgroup or 2-year landmark analyses, psychiatric intervention consistently showed a survival benefit in ALD patients. In the multivariate analysis, psychiatric intervention was identified as a favorable prognostic factor (hazard ratio, 0.780; P = 0.002 after PSM).
Conclusions
This study demonstrates the favorable effect of psychiatric intervention in ALD patients with psychiatric comorbidities. These findings emphasize the importance of integrated management for ALD patients to address both their medical and psychiatric aspects. Therefore, we suggest the potential benefits of early psychiatric interventions in improving survival outcomes in ALD.