title: Mental and Emotional Impairment in Patients With Hepatitis C is Related to Lower Work Productivity.
abstract: BACKGROUND
  Patients with Hepatitis C virus (HCV) have a higher risk of developing mental and emotional health (MEH) issues compared with the general population.
  
  
  OBJECTIVE
  Our aim was to assess the relationship between MEH and work productivity (WP) in patients with HCV.
  
  
  METHODS
  Patients with HCV enrolled in multinational clinical trials completed 4 questionnaires (Short Form 36 [SF-36], the Functional Assessment of Chronic Illness Therapy-Fatigue [FACIT-F], Chronic Liver Disease Questionnaire-Hepatitis C Virus [CLDQ-HCV], and the WP and Activity-Specific Health Problem [WPAI:SHP]) while they were not under treatment. The emotional domain (EM) of CLDQ-HCV, the role emotional, mental health, and the mental summary score of the SF-36 were used as the MEH indicators. We compared patients with an EM score of less than 4.66 (range: 1-7), which is the lowest quartile of emotional health, and those with an EM score of more than 6.33, which is the topmost quartile.
  
  
  RESULTS
  A total of 4333 patients were enrolled. Of those, 3,888 had MEH issues and WP data available. Patients were 52.3 ± 9.9 years old, 65.8% of them were male, 63.7% were treatment naïve, 19.7% were cirrhotic, 29.0% reported having a history of depression, and 18.7% had a history of anxiety. Patients at the top quartile of the EM were older, were more likely to be men, had less anxiety and depression, and were less likely to be cirrhotic and fatigued, but they were more likely to be employed as compared with the patients at the lowest quartile of the EM domain (all p < 0.0001). Furthermore, these patients had less WP impairment (0.023 ± 0.101 vs. 0.310 ± 0.288, p < 0.05). Multivariate regression analysis revealed that RE and EM were both predictive of WP scores (all p < 0.0001), presenteeism, and absenteeism (all p < 0.003).
  
  
  CONCLUSIONS
  In patients with HCV, impairment in MEH is predictive of lower WP.
authors.affiliation: Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, VA; Center for Outcomes Research in Liver Disease, Washington, DC.
authors.forename: Issah
authors.initials: I
authors.lastname: Younossi
authors.affiliation: Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, VA; Center for Outcomes Research in Liver Disease, Washington, DC.
authors.forename: Ali
authors.initials: A
authors.lastname: Weinstein
authors.affiliation: Center for Outcomes Research in Liver Disease, Washington, DC.
authors.forename: Maria
authors.initials: M
authors.lastname: Stepanova
authors.affiliation: Center for Outcomes Research in Liver Disease, Washington, DC.
authors.forename: Sharon
authors.initials: S
authors.lastname: Hunt
authors.affiliation: Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, VA; Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA. Electronic address: zobair.younossi@inova.org.
authors.forename: Zobair M
authors.initials: ZM
authors.lastname: Younossi
mesh_terms: D000041:Absenteeism; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology*; D017326:Clinical Trials, Phase III as Topic; D015331:Cohort Studies; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D004526:Efficiency; D004651:Employment; D005221:Fatigue / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014937:Work
chemical_list: D000998:Antiviral Agents