Emotional distress in chronic hepatitis C patients not receiving antiviral therapy

被引:96
作者
Fontana, RJ
Hussain, KB
Schwartz, SM
Moyer, CA
Su, GL
Lok, ASF
机构
[1] Univ Michigan, Sch Med, Dept Internal Med, Div Gastroenterol, Ann Arbor, MI 48109 USA
[2] Univ Michigan, Sch Med, Dept Psychiat, Ann Arbor, MI 48109 USA
[3] Univ Michigan, Sch Med, CHOICES, Ann Arbor, MI 48109 USA
关键词
mental health; depression; brief symptom inventory; health related quality of life; interferon; chronic hepatitis C;
D O I
10.1016/S0168-8278(01)00280-X
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background/Aims: The aim of our study was to determine the prevalence, type, and severity of emotional distress in a large group of consecutive chronic hepatitis C (CHC) patients not receiving anti-viral therapy. Methods: The brief symptom inventory and a 67-item questionnaire with the SF-36 embedded within it were used to study 220 outpatients with compensated CHC. Results: Seventy-seven (35%) participants reported significantly elevated global severity index (GSI) T-scores compared to an expected frequency of 10% in population controls. In addition, significantly elevated depression, anxiety, somatization, psychoticism, and obsessive-compulsive subscale T-scores were reported in 28-40% of subjects. Subjects with an active psychiatric co-morbidity had significantly higher GSI and subscale T-scores compared to subjects with active medical co-morbidities and subjects without medical or psychiatric co-morbidities (P < 0.01). However, patients with CHC alone also had a higher frequency of elevated GSI T-scores compared to population controls (20 versus 10%). GSI and subscale T-scores were strongly associated with SF-36 summary scores (P < 0.001). Conclusions: Clinically significant emotional distress was reported in 35% of CHC patients not receiving antiviral therapy. In addition to depression, a broad array of psychological symptoms were observed. Further investigation into the etiopathogenesis and treatment of emotional distress in CHC patients is warranted. (C) 2002 European Association for the Study of the Liver. Published by Elsevier Science B.V. All rights reserved.
引用
收藏
页码:401 / 407
页数:7
相关论文
共 53 条
[31]   PSYCHIATRIC-SYMPTOMS IN POLYSUBSTANCE ABUSERS - RELATIONSHIP TO RACE, SEX, AND AGE [J].
KENDALL, JC ;
SHERMAN, MF ;
BIGELOW, GE .
ADDICTIVE BEHAVIORS, 1995, 20 (05) :685-690
[32]   Emotional state, coping styles, and somatic variables in patients with chronic hepatitis C [J].
Kraus, MR ;
Schäfer, A ;
Csef, H ;
Scheurlen, M ;
Faller, H .
PSYCHOSOMATICS, 2000, 41 (05) :377-384
[33]   Gender differences in the reporting of physical and somatoform symptoms [J].
Kroenke, K ;
Spitzer, RL .
PSYCHOSOMATIC MEDICINE, 1998, 60 (02) :150-155
[34]  
KUHN WF, 1988, INT J PSYCHIAT MED, V18, P375
[35]   Morbidity of chronic hepatitis C as seen in a tertiary care medical center [J].
Lee, DH ;
Jamal, H ;
Regenstein, FG ;
Perrillo, RP .
DIGESTIVE DISEASES AND SCIENCES, 1997, 42 (01) :186-191
[36]  
LIPSITZ JD, 1994, AM J PSYCHIAT, V151, P1662
[37]  
Morlan KK, 1998, J CLIN PSYCHOL, V54, P885, DOI 10.1002/(SICI)1097-4679(199811)54:7<885::AID-JCLP3>3.0.CO
[38]  
2-E
[39]   Paroxetine for the prevention of depression induced by high-dose interferon alfa [J].
Musselman, DL ;
Lawson, DH ;
Gumnick, JF ;
Manatunga, AK ;
Penna, S ;
Goodkin, RS ;
Greiner, K ;
Nemeroff, CB ;
Miller, AH .
NEW ENGLAND JOURNAL OF MEDICINE, 2001, 344 (13) :961-966
[40]  
REGIER DA, 1988, ARCH GEN PSYCHIAT, V45, P977