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.