Depression, anxiety, post-traumatic stress, and alcohol-related problems among veterans with chronic hepatitis C.
OBJECTIVE
The aim of this study was to determine the incidence of psychiatric comorbidities among veterans with chronic hepatitis C.


METHODS
Depression, anxiety sensitivity, post-traumatic stress symptoms, and alcohol use were assessed using standardized questionnaires in 120 consecutive veterans with chronic hepatitis C referred to the Liver Clinic.


RESULTS
Using well-established scoring criteria of the questionnaires, clinically significant levels of depression (44.2%), anxiety (38.1%), post-traumatic stress disorder (20.8%), and alcohol-related problems (26.7%) were observed. The majority of patients had a clinically significant score for at least one questionnaire, whereas 37.2% had significant scores in two or more questionnaires. Positive correlations were found between post-traumatic symptoms and depressive symptoms, anxiety sensitivity, and alcohol use problems. Depressive symptoms were also correlated with anxiety. Responses to the questionnaires, in general, correlated poorly with psychiatric histories documented in the medical record. Overall, 79 (65.8%) patients had one or more possible contraindications to antiviral therapy: coexisting unstable psychiatric disorders and/or recent substance use was found in 73.4% of these patients.


CONCLUSIONS
Psychiatric comorbidities were very common among veterans with chronic hepatitis C and correlated poorly with diagnoses documented in the medical record. We recommend a multidisciplinary approach that includes psychological assessment using standardized questionnaires in the evaluation of these patients for antiviral therapy.
Lehman
Cassandra L
CL
Division of Gastroenterology and Hepatology, Veterans Affairs Palo Alto Health Care System, California 94304, USA.
Cheung
Ramsey C
RC
D000328:Adult; D000437:Alcoholism / Q000150:complications*; D001008:Anxiety Disorders / Q000150:complications; D003866:Depressive Disorder / Q000150:complications; D019698:Hepatitis C, Chronic / Q000150:complications / Q000523:psychology*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications*; D008875:Middle Aged; D013313:Stress Disorders, Post-Traumatic / Q000150:complications; D011795:Surveys and Questionnaires; D014481:United States; D014728:Veterans / Q000523:psychology*