Hepatic encephalopathy is classified as “overt” or “minimal,” depending on the presence or absence, respectively, of outward manifestations. Overt hepatic encephalopathy is seen in 30%−40% of people with cirrhosis , and one-third to one-half of hospitalizations for cirrhosis are related to overt hepatic encephalopathy . Minimal hepatic encephalopathy, which is the mildest form and is seen in up to 80% of people with cirrhosis, consists of deficits in immediate memory, attention, visuospatial abilities, and fine motor skills . Minimal hepatic encephalopathy increases the risk of progression to overt hepatic encephalopathy, impairs quality of life, including social interactions, and has been strongly associated with driving impairment . Minimal hepatic encephalopathy may be diagnosed with the aid of neuropsychiatric testing; the recommended batteries are the Psychometric Hepatic Encephalopathy Score and the Repeatable Battery for the Assessment of Neuropsychological Status . Mr. H’s results on the Repeatable Battery for the Assessment of Neuropsychological Status, with deficits in immediate memory, attention, and visuospatial construction, suggested the presence of minimal hepatic encephalopathy at baseline, although similar areas of cognitive impairment are found in schizophrenia , making it difficult to use these measures alone to identify minimal hepatic encephalopathy in patients with schizophrenia.