The risk of psychiatric disorders in patients with autoimmune hepatitis: a nationwide registry-based follow-up study

Background & Aims: Patients with autoimmune hepatitis (AIH) may have impaired quality of life and symptoms of depression and anxiety. Little is known about the long-term risk for psychiatric disorders. We conducted a population-based follow-up study on the risk of psychiatric disorders in patients with AIH and compared with the general population. Methods: From nationwide registries we identified all Danish patients diagnosed with AIH, 1994-2022, and matched population comparators. Based on hospital diagnoses and medical prescription data, we estimated the prevalence of psychiatric disorders at AIH diagnosis. Patients and comparators were followed through 2022, and we compared the risk of subsequent diagnoses of psychiatric disorders. Results: We included 1371 patients with AIH and 13,556 comparators with a median age of 54 years at AIH diagnosis. In the patients with AIH, 207 developed a psychiatric disorder during 13,798.6 years of follow-up (median follow-up: 8.8 years). One third of these patients developed more than one psychiatric disorder. The absolute risk for overall psychiatric disorders was 12.4% (95% CI 10.6-14.4) 10 years after AIH diagnosis. Depressive and anxiety disorders comprised the highest 10-year risk of 11.4% and 3.6%, respectively, and the same pattern applied to comparators. The overall 10-year risk of psychiatric disorders was similar in patients and comparators with an adjusted relative risk of 1.0 (95% CI 0.7-1.6), and this was the case for all psychiatric disorders. Conclusions: This nationwide study showed that the risk for psychiatric disorders was similar in patients with AIH and in population comparators.