Patients' expressions of complaints as a predictor of the course of acute hepatitis A.
OBJECTIVE
Physical complaints, emotional states, liver, and immune parameters were investigated as possible indicators of the course of hepatitis A.


METHODS
Forty-seven patients with hepatitis A were studied by means of the Giessen-Complaint-Inventory (GBB) and the Berlin Mood Questionnaire (BSF), as well as by taking into account their typical liver parameters and the following immune parameters: alphaInterferon (alphaIFN), soluble Interleukin 2 receptor (sIL-2R), Interleukin 6 (IL-6), Interleukin 1 receptor antagonist (IL-1Ra), and Immunoglobulin M or G (IgM, IgG). Two hundred twenty-nine medical students and a representative German sample (n = 1557, Braehler et al.) served as controls.


RESULTS
We found that the initial degree of change in permeability of the liver cells, complaints about abdominal symptoms, and extent of depressive mood were able to predict the length of hospital stay. Patients with the initial, more pronounced liver damage, as well as patients who articulated less subjective impairment proved to have a longer course of illness. Those patients who needed a significantly longer time for recovery report, at admission, very few complaints-fewer than even the normal population. We were not, however, able to demonstrate a significant difference in the investigated immune parameters.


CONCLUSIONS
A certain denial tendency seems to be harmful with respect to the recovery process and the immunological competence in the course of hepatitis A.
Rose
M
M
Department of Psychosomatic Medicine and Psychotherapy, Medical Clinic and Policlinic, Charité, Campus Virchow, Humboldt University, Augustenburger Platz 1, 13353, Berlin, Germany. rose@charite.de
Scholler
G
G
Jörres
A
A
Danzer
G
G
Klapp
B F
BF
D000208:Acute Disease; D000223:Adaptation, Psychological; D000328:Adult; D000339:Affect; D001294:Attitude to Health; D003717:Denial, Psychological; D003863:Depression / Q000175:diagnosis; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006506:Hepatitis A / Q000175:diagnosis* / Q000534:rehabilitation; D006760:Hospitalization; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D016898:Interferon-alpha / Q000097:blood; D007378:Interleukins / Q000097:blood; D007902:Length of Stay; D008297:Male; D011446:Prospective Studies; D011598:Psychoneuroimmunology; D011795:Surveys and Questionnaires
D007075:Immunoglobulin M; D016898:Interferon-alpha; D007378:Interleukins