Lifetime major depressive disorder is very common among patients with Wilson disease and is associated with worse mental health quality of life, found a new study based on an international Wilson disease registry. However, no link was found between liver or neurological disease and major depressive disorder in these patients.

The authors of the study that was published in the Journal of the Academy of Consultation-Liaison Psychiatry concluded that patients with Wilson disease should be screened for depression.

Read more about Wilson disease comorbidities

It is already known that patients with Wilson disease often experience psychiatric symptoms. However, these are seldom assessed systematically using validated measures.

Here, a team of researchers led by Paula Zimbrean, MD, from Yale University, Psychiatry in New Haven, reported the prevalence and clinical correlates for major depressive disorder among Wilson disease patients.

To do so, they used data from the Wilson disease registry, which was initiated at Yale University and is now a collaboration between multiple US and European sites. 

The team reported that 37% of the patients in the registry had a lifetime history of major depressive disorder and 6% met the criteria for active major depressive episodes. Almost a third (30.51%) of patients self-reported depression at the time of Wilson disease diagnosis. 

Moreover, Wilson disease patients with major depressive disorder had worse mental health quality of life scores compared to patients without major depressive disorder. They also had higher levels of severe anxiety and neuroticism. Finally, they had higher perceived stress. 

The researchers did not find any significant difference in physical health quality of life or the severity of neurological or liver disease between Wilson disease patients with or without major depressive disorder. 

There were also no significant differences in copper parameters or liver tests between the 2 groups of patients. 

“The limitations of our study consist in the small sample size, the cross-sectional report, and the lack of brain copper measurements,” the researchers said.


Camarata MA, Ala A, Coskun AK, et al. Major depressive disorder in an international multi-site Wilson disease registry. J Acad Consult Liaison Psychiatry. Published online December 13, 2022. doi:10.1016/j.jaclp.2022.12.001