title: Depressive symptoms are frequent among drug users, but not associated with hepatitis C infection.
abstract: OBJECTIVE
  To compare the prevalence and severity of depressive symptoms among drug users with and without hepatitis C virus (HCV) infection.
  
  
  METHODS
  This was a cross-sectional survey study carried out at the 2 major drug treatment centres on the island of Funen, Denmark. Participants were drug users presenting to the 2 treatment centres. Individuals with chronic hepatitis B virus or HIV infection were excluded. Participants completed the Major Depression Inventory (MDI) questionnaire when presenting at the centres. Patients with MDI scores indicating severe depression (total MDI score ≥ 35) were referred for treatment evaluation. Hepatitis C status was classified by the presence of anti-HCV as a marker of HCV exposure and HCV-RNA as a marker of ongoing infection.
  
  
  RESULTS
  Two hundred and sixty-eight patients were included, of whom 235 (88%) had complete serological testing; 100 (43%, 95% confidence interval (CI) 36-49%) had chronic hepatitis C. The median MDI score was 22 (interquartile range 12-33); 32% (95% CI 26-39%) had a score compatible with depression and 14% (95% CI 10-19%) were rated as severe depression. Depression was not associated with hepatitis C (HCV-infected 29%, non-infected 35%; p = 0.25). Forty-one percent (11/27) of the evaluated participants started antidepressant treatment.
  
  
  CONCLUSIONS
  Our study demonstrated a high prevalence of depressive symptoms among drug users, but this was not more frequent among HCV-infected patients. The high overall prevalence of depression underlines the relevance of screening for depression in patients who are drug users.
authors.affiliation: From the Department of Infectious Diseases, Odense University Hospital , Denmark.
authors.forename: Lone W
authors.initials: LW
authors.lastname: Madsen
authors.forename: Thilde
authors.initials: T
authors.lastname: Fabricius
authors.forename: Simon
authors.initials: S
authors.lastname: Hjerrild
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Hansen
authors.forename: Belinda K
authors.initials: BK
authors.lastname: Mössner
authors.forename: Inge
authors.initials: I
authors.lastname: Birkemose
authors.forename: Merete
authors.initials: M
authors.lastname: Skamling
authors.forename: Peer B
authors.initials: PB
authors.lastname: Christensen
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003718:Denmark / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology* / Q000473:pathology*; D055030:Drug Users; D005260:Female; D006526:Hepatitis C / Q000150:complications*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood; D019966:Substance-Related Disorders / Q000150:complications*
chemical_list: D018937:Hepatitis C Antibodies; D012367:RNA, Viral
keywords: Hepatitis C; depression; drug users