title: Mental and physical symptoms associated with lower social support for patients with hepatitis C.
abstract: OBJECTIVE
  To systematically examine the impact of the hepatitis C virus (HCV) diagnosis on patients' level of social support in a large-scale study.
  
  
  METHODS
  Patients evaluated and treated for HCV in a tertiary referral center were enrolled in a cross-sectional study. Demographic data, functional and emotional status as measured by the Hospital Anxiety and Depression Scale (HAD) and the Sickness Impact Profile (SIP), severity of liver disease, mode of acquisition, and physical and psychiatric comorbidities were collected from patients or abstracted from the medical record. All participants completed a semi-structured interview, addressing questions of social support.
  
  
  RESULTS
  A total of 342 patients (mean age 45.2 years; 37% women) were enrolled. Ninety-two (27%) patients described lower levels of support by family and friends. Nearly half of the participants (45%) noted the loss of at least one relationship due to the disease. Fears related to transmitting the disease (25%) were common and often associated with ignorance or even discrimination by others (19%). Nearly one fifth of the patients did not share information about their disease with others to avoid being stigmatized. Lower levels of social support were significantly associated with living alone, being unemployed, being excluded from antiviral therapy, having psychiatric comorbidities, contracting HCV through intravenous drug use, having high levels of anxiety and depression as measured by the HAD and negative mood state as measured by the SIP. Patients reporting lower levels of social support also noted more physical symptoms as measured by the SIP.
  
  
  CONCLUSIONS
  Patients with hepatitis C often face significant social problems, ranging from social isolation to familial stress. The most common concerns reflect a limited insight of patients and their relatives and friends about the disease, the risk factors for its spread, and about potential consequences. Our data suggest that educational interventions targeting support persons and the stressors identified in our findings may lessen or alleviate the social strains patients with hepatitis C experience.
authors.affiliation: Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System (151C-U) University Drive C, Pittsburgh PA 15240, USA. susan.zickmund@med.va.gov
authors.forename: Julie A
authors.initials: JA
authors.lastname: Blasiole
authors.forename: Laura
authors.initials: L
authors.lastname: Shinkunas
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Labrecque
authors.forename: Robert M
authors.initials: RM
authors.lastname: Arnold
authors.forename: Susan L
authors.initials: SL
authors.lastname: Zickmund
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D003627:Data Interpretation, Statistical; D005260:Female; D006526:Hepatitis C / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology*; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology; D012720:Severity of Illness Index; D012934:Social Isolation; D012944:Social Support
chemical_list: D000998:Antiviral Agents