Impact of Chronic Hepatitis C and Psychiatric Illness on Quality of Life

A substantial number of patients with chronic hepatitis C virus (HCV) infection have pre-existing mental health issues, and others develop conditions such as depression during treatment with interferon.

As reported in the July 2006 Journal of Clinical Gastroenterology, researchers from the Veterans Administration Palo Alto Health Care System conducted a study to determine the relative impact of chronic hepatitis C and co-morbid psychiatric illness on health-related quality of life (HRQoL).

The study included 864 veterans (201 HCV antibody positive and 663 HCV antibody negative) who had previously completed a veteran-specific HRQoL questionnaire (SF-36V) as part of the 1999 Veterans Administration Large Health Survey. The researchers compared HRQoL status and the prevalence of six major psychiatric diagnoses in subjects with and without HCV.

• Compared with the HCV negative group, the HCV positive veterans were more likely to have alcohol dependence (P < 0.001), depression (P = 0.01), and post-traumatic stress disorder (PTSD) (P < 0.004).
• The HCV positive group also reported lower HRQoL scores on 4 of the 8 SF-36V subscales (P < 0.01), and the mental component summary scale (P < 0.001).
• Even after adjusting for demographic variables and co-morbid psychiatric illness, HCV positive patients still had a significantly lower mental component summary score than HCV negative individuals (P < 0.01).
• Multiple regression analysis found that depression and PTSD predicted lower HRQoL scores for all 8 HRQoL subscales (P < 0.01), and for both the physical (P < 0.001) and mental (P < 0.03) component summary scales, independent of HCV status.

Conclusion

In conclusion, the authors wrote, “The HRQoL is significantly impaired in veterans with chronic hepatitis C, particularly the mental health components of HRQoL. In contrast, co-morbid depression and PTSD are associated with both lower physical and mental components of HRQoL, independent of chronic hepatitis C.”

Reference

J K Lim, R Cronkite, M K Goldstein, and others. The Impact of Chronic Hepatitis C and Comorbid Psychiatric Illnesses on Health-related Quality of Life. Journal of Clinical Gastroenterology 40(6): 528-534. July 2006.