Psychiatric Morbidity and its Effect on the Quality of Life of Patients with Chronic Hepatitis B and Hepatitis C

Özkan, Mine; Çorapçıoğlu, Aytül; Balcıoğlu, İbrahim; Ertekin, Erhan; Khan, Sila; Özdemir, Sebati; Karayün, Deniz; Ünsalver, Barış Önen; Kocaman, Nazmiye; Kaymakglu, Sabahattin; Köroğlu, Gültürk

doi:10.2190/d37y-x0jy-39mj-pvxq

Cited by 47 publications

(44 citation statements)

References 57 publications

(76 reference statements)

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“…Other studies have produced similar findings in chronic hepatitis B and C with measures of neuropsychiatric comorbidities, anxiety, and depression predicting higher fatigue levels(4, 5, 10, 11, 13, 14). Collectively, these findings provide important insight into specific patients who may subjectively experience greater fatigue, namely those with higher rates of depressed or anxious mood.…”

Section: Discussionsupporting

confidence: 59%

“…Studies assessing fatigue in HBV generally have been limited in sample size, and often have been part of larger studies that combined patients with various forms of liver disease(2, 4, 13, 15, 16). Other studies have used single item questions, assessment of serious adverse events, or subscales of HRQOL instruments to measure fatigue(3).…”

Section: Introductionmentioning

confidence: 99%

“…Almost all studies have had a primary emphasis on the broader construct of HRQOL which can be affected by numerous patient and environmental characteristics confounding the relationship with disease state(17). Symptoms, such as fatigue, are more directly associated with disease state, but often measured secondarily to HRQOL(2, 4, 14–16, 18). Taken together, standardized measures of fatigue have not been examined as a primary endpoint in any large North American cohort of patients with chronic HBV infection.…”

Section: Introductionmentioning

confidence: 99%

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Fatigue in Patients with Chronic Hepatitis B Living in North America: Results from the Hepatitis B Research Network (HBRN)

et al. 2016

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Background Fatigue is a common symptom of liver disease but not well-characterized in patients with chronic hepatitis B virus (HBV). Aims We assessed the rate of fatigue using a validated instrument in patients with HBV and identified demographic, virologic, and clinical features associated with fatigue in a cross-sectional cohort study from the Hepatitis B Research Network (HBRN). Methods Participants were English and Spanish-speaking adults with chronic HBV who were not pregnant nor on treatment. Fatigue was measured using the PROMIS® Fatigue 7-item Short Form. Results The sample included 948 adults: median age 42; 51% female; 71% Asian; 74% college educated; 77% employed; 41% inactive HBV carriers; 36% with active chronic disease; and 2% with advanced fibrosis, defined as AST-Platelet Ratio Index (APRI) > 1.50. Patients with chronic HBV had a mean fatigue T-score of 46.8 ±SD=7.9, compared to a mean fatigue T-score of 50.0 ± 10 in the U.S. general population (p<.0001). In univariate analyses, greater fatigue was associated with demographic and clinical features such as female sex, lower income, more comorbidities, higher APRI score, and poorer mental health (p<0.05). In multivariate analysis, female sex (p<.001), poorer mental health (p <.001), APRI score (p=.005) and history of diabetes (p=.039) were the strongest independent predictors. Conclusions The frequency of fatigue in this large cohort of North American chronic HBV patients may be equal to or lower than that reported in the U.S. general population. Patients with advanced fibrosis, more comorbidities, and poorer mental health report worse fatigue.

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Section: Discussionsupporting

confidence: 59%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Fatigue in Patients with Chronic Hepatitis B Living in North America: Results from the Hepatitis B Research Network (HBRN)

et al. 2016

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“…Like other studies, higher depression scores were the strongest predictor of lower HRQOL on both measures. A study by Ozkan et al [34] found that psychiatric comorbidity (especially depression) was the strongest predictor of reduced HRQOL in Turkish patients with hepatitis B and C. There were no significant differences in HRQOL between patients with HBV and those with HCV, but HRQOL was lower in both groups than in healthy control subjects on all SF-36 scales. Patients with HCV and a psychiatric diagnosis had significantly lower HRQOL than patients with HCV who did not have a psychiatric diagnosis (Table 1).…”

Section: Resultsmentioning

confidence: 91%

Health-related quality of life in HCV-infected patients

Groessl

Weingart²,

Kaplan³

et al. 2007

Curr hepatitis rep

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In March 2007, a systematic review was conducted of published research on the topic of health-related quality of life (HRQOL) in patients with hepatitis C virus (HCV) infection. Recent studies indicate that significant decrements in HRQOL exist for patients with HCV under many circumstances and arise from multiple sources. Future research is needed on finding interventions that address all sources of reduced HRQOL in patients with HCV, whether or not they are on treatment. It is also important to continue work on identifying the direct mechanisms behind lower HRQOL in patients with HCV.

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“…However, a Turkish study found a Acupuncture for depression and myalgia in patients with hepatitis: an observational study high rate of psychiatric disorders and no signifi cant difference between the two groups. 5 Psychotherapy and antidepressant drugs are known to be useful but high rates of dropout, lack of effect in some patients, intolerable adverse effects and relapse all reduce their effectiveness and patient compliance. [6][7][8] In consequence, patients with depression may seek alternative treatments.…”

Section: Introductionmentioning

confidence: 99%

Acupuncture for Depression and Myalgia in Patients with Hepatitis: An Observational Study

et al. 2010

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Background Depressive symptoms and myalgia are commonly seen in patients with chronic hepatitis B and chronic hepatitis C. Objective To investigate the effi cacy of acupuncture treatment on depressive symptoms and myalgia in patients with hepatitis. Methods Of 44 patients with hepatitis screened for depression and myalgia, 28 were enrolled and included in the study. The main outcome measure for depressive symptoms was Beck's Depression Inventory (BDI). For pain/myalgia, patients rated their pain on a scale from 0 to 10. Patients with a score greater than the cut-off point in either score were allocated to acupuncture treatment. The Chinese method of acupuncture was used. Treatment continued for 6 weeks. Results At baseline, 17/44 patients (39%) had a BDI score ≥17 and 24 (55%) had a pain score ≥5. A total of 28 patients were allocated to acupuncture treatment, forming three groups: group 1, 13 patients with high BDI and high myalgia scores; group 2, 11 patients with low BDI score but high myalgia score; group 3, 4 patients with high BDI score but low myalgia score. Adherence to treatment was good; all patients completed the sessions and there were no drop-outs. Signifi cant improvements in end-treatment BDI and in myalgia scores compared with baseline levels was found. Conclusion Acupuncture seems to be a promising treatment for patients with hepatitis. Further studies are warranted in large populations to establish the therapeutic role of acupuncture. INTRODUCTIONThe estimated numbers of patients with chronic hepatitis C (CHC) and B (CHB) viral infections in the world are 2.7 million and 350 million, respectively. 1 2 Depressive symptoms are common in these patient groups. Increased expression of specifi c proinfl ammatory cytokines has been shown to cause depressive symptoms in patients with hepatitis C virus. Additionally, treatment of the disease with interferon (IFN) may also cause or exacerbate depression.3 4 Reports suggest that depression in patients with CHB develops less frequently than in patients with CHC during treatment with IFN. However, a Turkish study found a Acupuncture for depression and myalgia in patients with hepatitis: an observational study high rate of psychiatric disorders and no signifi cant difference between the two groups. 5Psychotherapy and antidepressant drugs are known to be useful but high rates of dropout, lack of effect in some patients, intolerable adverse effects and relapse all reduce their effectiveness and patient compliance. [6][7][8] In consequence, patients with depression may seek alternative treatments.Acupuncture has long been used to treat emotional and psychological disorders, including anxiety, insomnia and depression. It may also be an alternative treatment of depressive symptoms in patients with CHB or CHC. In our patients with hepatitis, we have found that in addition to depression, myalgia is also common. Therefore, the objective of this study was to determine the prevalence of depressive symptoms and myalgia among patients with chronic hepatitis and ...

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Psychiatric Morbidity and its Effect on the Quality of Life of Patients with Chronic Hepatitis B and Hepatitis C

Abstract: Chronic hepatitis B and C patients presented a high rate of psychiatric disorder. HRQL was significantly decreased in patients with psychiatric morbidity.

Cited by 47 publications

References 57 publications

Fatigue in Patients with Chronic Hepatitis B Living in North America: Results from the Hepatitis B Research Network (HBRN)

Fatigue in Patients with Chronic Hepatitis B Living in North America: Results from the Hepatitis B Research Network (HBRN)

Health-related quality of life in HCV-infected patients

Acupuncture for Depression and Myalgia in Patients with Hepatitis: An Observational Study

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