Incidence of Depression and Anxiety in a Cohort of Adolescents With Nonalcoholic Fatty Liver Disease.

OBJECTIVES: To determine the incidence of clinically diagnosed depression and anxiety in adolescents with nonalcoholic fatty liver disease (NAFLD). METHODS: This was a prospective, longitudinal cohort study between January 1, 2012 and July 1, 2018 conducted in a Children's Hospital Pediatric Gastroenterology Clinic. Participants included adolescents 12 to 17 years old at baseline with biopsy-confirmed NAFLD. The primary outcomes were having depression and/or anxiety based upon a clinical diagnosis established by a physician or psychologist. The rates of depression and anxiety were measured at baseline and longitudinally throughout follow-up. RESULTS: A total of 160 adolescents with NAFLD were followed for a mean of 3.8 years. At baseline, 8.1% had a diagnosis of depression. During follow-up, an additional 9.5% (95% confidence interval, 4.7-14.3) developed depression. The incidence density of depression was 27 new cases per 1000 person-years at risk. In adolescents with NAFLD, 6.3% had anxiety at baseline and 6.7% (95% confidence interval, 2.6-10.7) developed anxiety during follow-up. The incidence density of anxiety was 18 new cases per 1000 person-years at risk. The change in alanine aminotransferase was significantly worse for adolescents with NAFLD who developed depression compared to those who did not develop depression (P < 0.01). CONCLUSIONS: Adolescents with NAFLD had a high incidence of clinically diagnosed depression and anxiety. The rates were higher than expected relative to the available data in the general population. Addressing this mental health burden will require efforts at both the patient level and the systems level.

A Bibliometric Analysis of Clinical and Translational Research in Pediatric Gastroenterology From 1970 to 2017.

OBJECTIVES: Pediatric gastroenterology is a clinical and research discipline principally developed over the past 50 years. Bibliometric methods provide quantitative analysis and identify research trends. Study aims were to characterize the growth and trends in pediatric gastroenterology clinical and translational research using citation analysis. METHODS: Using citations analysis software, a search strategy specific for pediatric gastroenterology was implemented for the years 1970 to 2017. The 50 most-cited research articles per decade were identified. These 250 articles were coded for topic and study attribute. Analysis included authors, affiliations, journals, countries, and funding sources. RESULTS: Overall average annual growth rate for pediatric gastroenterology publications was significantly higher than that for general pediatrics (51.7% vs 6.2%; P < 0.05). Among the top 250 cited articles, the distribution of study focus was epidemiology (43%), pathophysiology (18%), treatment (16%), diagnosis (8%), prevention (8%), and comorbidities of gastrointestinal diseases (7%).There were 38 different topics represented and there was a notable shift in topic focus over time. Cholestasis, biliary atresia, and total parenteral nutrition were common topics from 1970 to 1989 and obesity, nonalcoholic fatty liver disease, and eosinophilic esophagitis were common topics after 1990. Notably, 2.3% of the authors accounted for 30% of the top 250 articles. CONCLUSIONS: Pediatric gastroenterology research has undergone rapid growth yielding advancements in the management of gastrointestinal conditions in children. The emergence of new diseases in need of better diagnostics and therapeutics led to a temporal shift in research focus. Further advancements will require multidisciplinary collaborations and continued funding for pediatric gastroenterology research.