الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
Nonalcoholic liver disease (NAFLD) is one of the most common liver diseases worldwide and cause both hepatic and extrahepatic manifestations with both morbidity and mortality affection.
Depression is the most common mental disorder and cognitive impairment is an important disease with cause high burden and morbidity.
Several studies suggested correlation between NAFLD and other mental disorders while other studies suggested no relation.
Our study hypothesized that depression and cognitive impairment would be related to NAFLD and investigate if depression and cognitive affection are extrahepatic manifestations to NAFLD.
This work aims to assess presence of depression and cognitive impairment in patients with NAFLD and examine whether the presence of cognitive affection is partially explained by depression.
After announcement of patient about our study, participants are recruited from hepatology and radiology clinics then underwent full clinical history and examination with laboratory investigations to see if patients are eligible for our study or not according to inclusion and exclusion criteria.
After that our team choose HAMD to assess presence of depressive symptoms and their severity and MoCA for assessment of cognitive impairment.
After analysis of the results, it was clear that there is strong correlation between both depression, cognitive affection and NAFLD.
Also, we found that severity of the NAFLD is positively correlated with depression severity.
Visuospatial and executive function domains are the most affected among NAFLD patients which is correlated with other studies.
B. Conclusions:
Based on our study analysis we can conclude that there is relation between depression and NAFLD and could be an extrahepatic manifestation of the disease. We also concluded that increase severity of NAFLD lead to increase severity of depression and vice versa. Cognitive impairment risk increases with patient of NAFLD and visuospatial and executive domains are most affected. NAFLD as an isolated risk factor for cognitive impairment cannot be assessed as they are interrelated factors.
C. Limitations:
1. The study was one center study and our result cannot be generalized to other centers.
2. The authors used available methods for detection of fatty liver severity by abdominal ultrasound while histological examination is the most accurate.
3. For detection of brain affection usage of functional MRI is not available in our center which is more accurate.
D. Recommendation:
1. Increase awareness of other specialties especially hepatologist by scanning of depressive and cognitive impairment symptoms at patients with NAFLD for rapid interventions as comorbidity may increase disease burden.
2. Usage of other advanced modalities for assessment of the relation between NAFLD and mental illness.
3. Scanning for presence of fatty liver among depressant and patient with cognitive impairment by abdominal ultrasonography.
4. Multicentric researches for the relation between NAFLD and mental illnesses.