Psychological impact of chronic hepatitis C: comparison with other stressful life events and chronic diseases.
OBJECTIVE
To examine the psychological impact of chronic hepatitis C (CHC) diagnosis in a large cohort of CHC patients as compared with other stressful life events and chronic diseases carrying a risk of life-threatening complications.


METHODS
One hundred and eighty-five outpatients with compensated CHC were asked to self-grade, using a 100-mm visual analogue scale (VAS), the degree of stress caused by the learning of CHC diagnosis and the perceived severity of their disease. Diagnosis-related stress was compared to four other stressful life events and perceived CHC severity was compared to four other common chronic diseases.


RESULTS
Learning of CHC diagnosis was considered a major stressful event (mean+/-SD scores: 72+/-25), significantly less than death of a loved-one (89+/-13, P<0.0001) and divorce (78+/-23, P<0.007), but more than job dismissal (68+/-30, P<0.04) and home removal (26+/-24, P<0.0001). CHC was considered a severe disease (74+/-19), after AIDS (94+/-08, P<0.001) and cancer (91+/-11, P<0.001), but before diabetes (66+/-23, P<0.001) and hypertension (62+/-20, P<0.001). Perceived CHC severity was not related to the actual severity of liver disease, assessed according to Metavir fibrosis score. In multivariate analysis, diagnosis-related stress was related to perceived disease severity (P<0.001), trait anxiety (P<0.001) and infection through blood transfusion (P<0.001).


CONCLUSIONS
Our results show the considerable psychological and emotional burden that a diagnosis of CHC represents, even in the absence of significant liver disease. They should be taken into account when announcing a diagnosis of CHC in order to reduce its negative effects.
Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut Lévêque, Avenue Magellan, 33604 Pessac, France. laurent.castera@chu-bordeaux.fr
Laurent
L
Castera
Aymery
A
Constant
Pierre-Henri
PH
Bernard
Victor
V
de Ledinghen
Patrice
P
Couzigou
D000328:Adult; D002908:Chronic Disease / Q000523:psychology*; D005260:Female; D019698:Hepatitis C, Chronic / Q000523:psychology*; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011788:Quality of Life; D012647:Self-Assessment; D012720:Severity of Illness Index; D013315:Stress, Psychological