title: Psychiatric disorders among veterans with hepatitis C infection.
abstract: OBJECTIVE
  The presence of psychiatric, drug-, and alcohol-use disorders in hepatitis C virus (HCV)-infected patients may influence their management and prognosis. The frequency and the risk for these disorders among HCV-infected patients are unknown.
  
  
  METHODS
  We identified all HCV-infected veteran patients who were hospitalized during 1992-1999 and searched the inpatient and outpatient computerized files for predefined psychiatric, drug-, and/or alcohol-use disorders. We then performed a case-control study among Vietnam veterans; controls without HCV were randomly chosen from hospitalized patients.
  
  
  RESULTS
  We identified 33,824 HCV-infected patients, in whom 86.4% had at least one past or present psychiatric, drug-, or alcohol-use disorder recorded. However, only 31% had active disorders as defined by hospitalization to psychiatric or drug-detoxification bed sections. There were 22,341 HCV-infected patients from the Vietnam period of service (cases) who were compared with 43,267 patients without HCV (controls). Cases were more likely to have depressive disorders (49.5% vs. 39.1%), posttraumatic stress disorder (PTSD) (33.5% vs. 24.5%), psychosis (23.7% vs. 20.9%), bipolar disorder (16.0% vs. 12.6%), anxiety disorders (40.8% vs. 32.9%), alcohol (77.6% vs. 45.0%), and drug-use disorders (69.4% vs. 31.1%). In multivariable regression analyses that adjust for age, sex, and ethnicity, drug use, alcohol-use, depression, PTSD, and anxiety remained strongly associated with HCV.
  
  
  CONCLUSIONS
  Several psychiatric, drug-, and alcohol-use disorders are commonly found among HCV-infected veterans compared with those who are not infected. At least one third of these patients have active disorders. A multidisciplinary approach to the management of HCV-infected patients is needed.
authors.affiliation: Section of Gastroenterology, The Houston Center for Quality Care and Utilization Studies, The Houston Veterans Affairs Medical Center and the Department of Medicine, Baylor College of Medicine, Houston, Texas 77030, USA. hsheme@bcm.tmc.edu
authors.forename: Hashem B
authors.initials: HB
authors.lastname: el-Serag
authors.forename: Mark
authors.initials: M
authors.lastname: Kunik
authors.forename: Peter
authors.initials: P
authors.lastname: Richardson
authors.forename: Linda
authors.initials: L
authors.lastname: Rabeneck
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D006526:Hepatitis C / Q000523:psychology*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D019966:Substance-Related Disorders / Q000453:epidemiology; D014728:Veterans