Depressive Symptoms, Sleep Quality, and Anhedonia in Patients with Primary Biliary Cholangitis: A Cross-Sectional Study

Background and aim: This study assessed depressive symptoms, sleep quality, and anhedonia in patients with primary biliary cholangitis (PBC), compared them with healthy controls (HCs), and explored their associations with UDCA treatment response, established prognostic scores, and liver stiffness measurement (LSM) in patients with PBC. Methods: In this single-center cross-sectional study, 103 patients with PBC and 50 HCs were evaluated using three validated patient-reported outcome (PRO) instruments: the Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and Snaith–Hamilton Pleasure Scale (SHAPS). PRO measures were compared between patients with PBC and HCs, and associations between PROs and UDCA treatment response, prognostic scores, and LSM were explored in the PBC group. Results: Moderate-to-severe depressive symptoms, poor sleep quality, and anhedonia were observed in 45%, 62%, and 36% of patients with PBC, respectively, compared with 18%, 38%, and 18% of HCs. The age- and sex-adjusted odds ratios (ORs) for PBCvs. HC were 3.889 (95% CI 1.695–8.926), 3.442 (95% CI 1.636–7.238), and 2.678 (95% CI 1.158–6.193), respectively. Younger age was independently associated with poor sleep quality (OR per year 0.946, 95% CI 0.898–0.997; p = 0.039). No statistically significant associations were identified between PROs and UDCA response, prognostic scores, and LSM in patients with PBC. Conclusions: Patients with PBC reported a substantial and interrelated burden of depressive symptoms, poor sleep quality, and anhedonia compared with HCs.