The association between hepatitis B self‐awareness and depression: Exploring the modifying effects of socio‐economic factors

Abstract

China has a high prevalence of HBV. Despite previous studies, uncertainty remains about the association of HBV with depression. This study explores the strength of the association and the modifying effects of participants' self-awareness of the disease and their socio-economic status. Data from the baseline of a Chinese cohort study of approximately 500 000 adults were analysed. Depression was assessed using the Composite International Diagnostic Inventory. Blood spot tests were conducted to detect hepatitis B surface antigen. Logistic regression was used to assess the association between depression and HBV adjusting for demographic, socio-economic and lifestyle factors of major depression. To understand the effect modifications of disease self-awareness and socio-economic factors, a series of stratified analyses were undertaken. The overall prevalence of HBV is 3.2%, with 2.8% screen-detected and 0.3% self-reported cases. There was an 84% increased odds of depression among self-reported HBV patients (OR=1.84, 95% CI: 1.16-2.90), but no association was found in the screen-detected group (OR=0.98, 95% CI: 0.79-1.23). Male (OR=2.28, 95% CI: 1.30-3.98), younger age (OR=3.57, 95% CI: 1.82-7.00), rural resident (OR=2.31, 95% CI: 1.36-3.94), lower household income (OR=2.38, 95% CI: 1.34-4.25) and agricultural worker (OR=2.92, 95% CI: 1.63-5.77) were found having greater odds of depression in the HBV self-aware group, compared to those without HBV. A strong association between hepatitis B self-awareness and depression was found. Lower socio-economic status could modify the association between hepatitis B status and depression. Further studies are needed to understand the underlying psychosocial mechanisms of the association.

Nonliver Comorbidities in Patients With Chronic Hepatitis B

“…However, these findings may be confounded by social stigma. For patients who had CHB but were unaware of their status, there was no statistically significant difference in having major depression . Although development of mental illness may be attributable, at least in part, to discrimination or fear of discrimination, this perception carries significant consequences for patients with CHB …”

“…In a related study, Zhu et al found that the higher the Child‐Pugh rating, the higher patients scored on two widely used depression and anxiety scales (Hamilton Depression Scale and Hamilton Anxiety Scale). In another China‐based study, controlled for socioeconomic factors, awareness of having hepatitis B increased odds of major depression (OR 1.84 [95% CI: 1.16‐2.90]) compared with patients without hepatitis B . However, these findings may be confounded by social stigma.…”

“…In another China-based study, controlled for socioeconomic factors, awareness of having hepatitis B increased odds of major depression (OR 1.84 [95% CI: 1.16-2.90]) compared with patients without hepatitis B. 26 However, these findings may be confounded by social stigma. For patients who had CHB but were unaware of their status, there was no statistically significant difference in having major depression.…”

“…For patients who had CHB but were unaware of their status, there was no statistically significant difference in having major depression. 26 Although development of mental illness may be attributable, at least in part, to discrimination or fear of discrimination, this perception carries significant consequences for patients with CHB. [27][28][29] aDverse eFFeCTs OF anTiviral THeraPY Currently, there is no cure for CHB, so the emphasis of management is on prevention through vaccination.…”

Analysis Of Agricultural Logistics Literatures Based On Cnki

“…So we choose the Zipf's second law to get the threshold n of high frequency words. Zipf's second law is a very important law in bibliometrics [5]. The predecessors have proposed the critical value calculation formula of high-frequency words and low-frequency words according to Zipf's second law,which is,…”