title: The effect of suppressive oral acyclovir on the psychological morbidity associated with recurrent genital herpes.
abstract: OBJECTIVE
  To assess the psychological impact of recurrent genital herpes and to determine if longterm acyclovir has any impact on this morbidity.
  
  
  METHODS
  Patients with frequently recurring genital herpes attending a department of genitourinary medicine who were considered suitable for longterm acyclovir.
  
  
  METHODS
  Patients completed an 80 item, self-administered psychological questionnaire before starting acyclovir and every three months for one year. Treatment was then stopped and three months later a further questionnaire was completed. The questionnaire consisted of the General Health Questionnaire (GHQ); the Hospital Anxiety and Depression Questionnaire (HADQ); Illness Attitude Scales and Illness Concern. Data were analysed by McNemar's test for changes in proportions and by Wilcoxon's test for changes in scores.
  
  
  RESULTS
  102 patients were recruited: 55 men, and 47 women. Eighty two (80%) patients completed three months treatment, 75 (74%) six months, 64 (63%) nine months and 61 (60%) a year. Fifty (49%) of the original 102 patients completed the three months post treatment follow up. At first visit 63% (64/102) were designated as GHQ "cases". Within three months this decreased to 26% (21/82). McNemar's test showed that 67% (34/51) of the patients who were initially classified as GHQ "cases" became "noncases" after three months (p < 0.0001). There was a significant decrease in the proportion of HAD anxiety cases from visit one to visit two (p < 0.0001) and a decrease in illness concern scores from visit one to visit two (p < 0.0001). All these decreases were maintained throughout the years treatment with acyclovir.
  
  
  CONCLUSIONS
  There is a substantial morbidity associated with frequently recurring genital herpes. However, acyclovir suppression significantly reduces illness concern and anxiety and is a useful addition to the treatment of this infection.
authors.affiliation: Academic Department of Genitourinary Medicine, University College & Middlesex School of Medicine, Middlesex Hospital, London.
authors.forename: O
authors.initials: O
authors.lastname: Carney
authors.forename: E
authors.initials: E
authors.lastname: Ross
authors.forename: G
authors.initials: G
authors.lastname: Ikkos
authors.forename: A
authors.initials: A
authors.lastname: Mindel
mesh_terms: D000212:Acyclovir / Q000008:administration & dosage*; D000328:Adult; D001007:Anxiety / Q000628:therapy; D003863:Depression / Q000628:therapy; D004334:Drug Administration Schedule; D005260:Female; D006558:Herpes Genitalis / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D008297:Male; D009017:Morbidity; D012008:Recurrence; D013997:Time Factors
chemical_list: D000212:Acyclovir