Psychiatric aspects in hepatitis C infection

Abstract EN

Background una aim: Psychiatric symptoms and emotional distress appear to be more common in chronic hepatitis C (CHC) patients than in the general population.

The aim of this study was to assess the psychiatric disorders in hepatitis C infection in cases not receiving anti-viral therapy in a rural community of Upper Egypt (Sallam village).

Methods: In a cross- sectional study, 86positive anti-HCV cases, aged 15-65 years old and 60 control subjects of matched age and sex participated in this study.

Assessment was done using standardized questionnaires including Hamilton anxiety rating scale (HARS), Hamilton checklist ofsymptoms of depressive illness, symptom checklist -90 (SCL-90) and social scale assessment.

In addition to clinical, physical, ultrasonographic examinations and laboratory assessment including urinalysis, blood sugar, hepatitis B surface antigen (HBsAg), HCV antibody and HCV RNA by polymerase chain reaction (PCR).

Results: The mean age was 40.29+15.75.

Fifty cases (58.1%) were HCV RNA positive, whereas 36 cases (41.9%) were negative.

The mean score of the nine subscales of SCL-90 were significantly higher in HCV-antibody positive cases than in controls and the mean score of the nine subscales ofSCL-90 were significantly higher in positive HCV-RNA cases than in controls except for those with paranoia.

Moreover, the mean scores of the nine subscales were significantly higher in negative HCV-RNA cases than controls except for those with anxiety and phobia.

The previous parameters were higher in HCV RNA positive than in negative cases but without significant difference.

The frequencies of depressive cases (>18 degrees) and severe cases (>26 degrees) were significantly higher in HCV antibody cases [25 (29.1%) and 6 (7%)] than in controls [3(5%) and 0%f (P<0.001 and P<0.05 respectively).

The frequencies of mild and moderate depressive cases were significantly higher in HCV RNA positive cases than in controls (P<0.01 and P<0.05 respectively but only in mild cases for those with HCV RNA negative cases.

However, the frequency of depressive cases (>18degrees) was significantly higher in both positive [16(32%)] and negative [9(25%)] HCV RNA than in controls [3(5%)] (P<0.001 and P<0.01 respectively).

There was a significant difference between mild anxiety cases (15-28 degree) and also anxiety cases > 15 degrees in HCV antibody positive cases (41.9%) than in controls (13.3%) (P<0.001 and P<0.001 respectively).

The same previous results were obtained on comparison of positive HCV RNA and negative cases versus controls (P<0.01 and P<0.001 respectively).

Although the frequency of severe anxiety cases (> 29 degree) was higher in positive HCV RNA cases [4 (8%)] than in controls [1 (1.7%)] but without significant difference (P=0.056).

No significant association was found between ALT levels and depressive as well as anxiety cases in HCV RNA positive cases and also, no significant correlation was found between the score of the nine SCL90 subscales and the level of ALT in HCV RNA positive cases.

Conclusion: Psychiatric disorders as anxiety and depression and also, the nine SCL-90 subscales were significantly higher in HCV RNA positive or negative cases than in controls.

Although, the previous parameters were higher in HCV RNA positive than in negative cases but without significant difference.

These results may be due to the patients concern about the potentially serious health consequence of CHC infection.