Quality of life in cirrhotics with minimal hepatic encephalopathy

Minimal hepatic encephalopathy (HE) is a major cause of premature retiremen t in cirrhotics. The decision on the earning capability of a patient is usu ally based on clinical judgement, considering the patient's complaints and clinical findings such as nervousness and depression. In a comprehensive ps ychometric study we were able to show that cirrhotic patients, who are cons idered to be unable to earn their living, differ significantly from those w ho are working, in tests evaluating psychomotor function and in personality and subjective well-being scores representing nervousness, aggressiveness, depression. The latter scores are considered to represent the individual d iscrepancies between professional demands and cerebral performance. Since m inimal HE affects psychomotor function but not verbal abilities this discre pancy exists predominantly in "blue collar workers." In accordance with thi s 60% of "blue collar" (in contrast to 20% of "white collar") workers of ou r patient group were considered unfit for work. Working ability is an essen tial element of quality of life in Western societies. Thus, an impairment o f working capability is of major impact on quality of life in cirrhotics.