PSYCHOLOGIC STRESS, DEPRESSION AND QUALITY OF LIFE IN PATIENTS WITH LIVER DISEASE DUE TO HEPATITIS C VIRUS

N. Singh^{*}, T. Gayowski, M.M. Wagener, I.R. Marino. Veterans Affairs Medical Center, Pittsburgh, PA.

Background:
Quality of life is frequently compromised by chronic illnesses. While numerous studies have assessed the clinical impact of hepatitis C virus (HCV) hepatitis, the psychosocial sequelae and quality of life impairment in patients with liver disease due to HCV is not known.

Methods:
Depression, psychologic stress and quality of life was prospectively assessed in 82 liver transplant candidates. Comparisons were made between patients with HCV hepatitis (n=42) versus patients with other liver diseases (n=40). Depression was assessed by Beck Depression Inventory, emotional stress by Profile of Mood States scale (POMS), coping by Ways of Coping scale, and stressful life events by Recent Events Inventory. Quality of life measure included a self-assessed rating of perceived quality of life.

Results:
Patients with HCV were significantly younger than all other patients (p=.002). Emotional stress, i.e., total mood disturbance score (p=.038), tension and anxiety (p = .047) and confusion and bewilderment (p=.035) were significantly higher in patients with HCV. Patients with HCV were significantly more depressed as assessed by Beck Depression Inventory scores (p = .014) and had significantly greater impairment in Beck inventory items pertaining to somatic manifestations of depression (perceptions of body images, work inhibition, sleep disturbance, fatigue, appetite and weight loss, somatic preoccupation) than all other patients (p = .018). A significantly higher number of patients with HCV reported experiencing pain (p=.001). There was no difference in coping, social support, religious support, education, employment, income, Karnofsky score, Child-Pugh score, or liver function tests between patients with HCV versus all other patients.

Conclusion:
Patients with HCV hepatitis are uniquely vulnerable to depression and psychological stress in the pretransplant period than all other patients. Symptoms of depression should be sought in these patients since depression is a treatable and modifiable disorder.


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