title: Health-related quality of life and depression in patients with chronic hepatitis C.
abstract: BACKGROUND
  Hepatitis C is a major cause of liver disease worldwide. It has been associated with decreased health-related quality of life (HRQL) and psychiatric symptoms. Our aim was to assess HRQL, depression, and illness understanding in patients with chronic hepatitis C without previous interferon therapy.
  
  
  METHODS
  Consecutive patients attending a referral center were enrolled. HRQL was measured using SF-36 questionnaire, depression with Zung self-rating depression scale, and illness understanding with self-applied knowledge test.
  
  
  RESULTS
  Of 157 patients enrolled, 112 were female (71%) and 45 male (29%). Ninety-seven patients (61.8%) had cirrhosis. HRQL was significantly decreased in chronic hepatitis C patients compared to historical normal controls in all eight domains of the SF-36 (p < 0.001). In hepatitis C cirrhotic patients, HRQL was significantly lower among Child-Pugh class B and C subjects in domains reflecting physical health (p <0.05). Ninety-two patients (58.6%) had depression that resulted in lower HRQL when compared to nondepressed patients (p <0.05). One hundred fourteen patients (72.6%) had poor illness understanding of hepatitis C. These subjects had significantly lower HRQL scores in six of eight SF-36 domains when compared to patients with better understanding of the disease (p <0.05).
  
  
  CONCLUSIONS
  Chronic hepatitis C patients attending a tertiary-referral center had significant decrease in HRQL associated with depression (58.6%) and poor illness understanding (72.6%). Educational programs and their impact on HRQL need to be addressed in detail, particularly for the pre-treatment scenario.
authors.affiliation: Departamento de Gastroenterologi;a, Instituto Nacional y de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico. kesd@quetzal.innsz.mx
authors.forename: Juan Fernando
authors.initials: JF
authors.lastname: Gallegos-Orozco
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: Fuentes
authors.forename: Juan
authors.initials: J
authors.lastname: Gerardo Argueta
authors.forename: Christian
authors.initials: C
authors.lastname: Pérez-Pruna
authors.forename: Carlos
authors.initials: C
authors.lastname: Hinojosa-Becerril
authors.forename: Ma Sara
authors.initials: MS
authors.lastname: Sixtos-Alonso
authors.forename: Socorro
authors.initials: S
authors.lastname: Cruz-Castellanos
authors.forename: Gabriela
authors.initials: G
authors.lastname: Gutiérrez-Reyes
authors.forename: Marco Antonio
authors.initials: MA
authors.lastname: Olivera-Martínez
authors.forename: Ma Concepción
authors.initials: MC
authors.lastname: Gutiérrez-Ruiz
authors.forename: David
authors.initials: D
authors.lastname: Kershenobich
mesh_terms: D001294:Attitude to Health; D003863:Depression / Q000150:complications*; D005260:Female; D005355:Fibrosis / Q000150:complications / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006526:Hepatitis C / Q000150:complications* / Q000523:psychology; D006801:Humans; D008297:Male; D011788:Quality of Life; D011795:Surveys and Questionnaires