Hepatitis and psychiatric symptoms [Epatite e sintomi psichici]

Objectives: Aim of the study, part of a larger perspective study, is to examine the presence of psychiatric symptoms or disorders in patients with chronic hepatitis C and/or B virus. We also evaluated whether this kind of symptoms are more manifest in patients with chronic HCV than in those with HBV as previously reported. Methods: 60 patients (18 with chronic HBV, 39 with chronic HCV, and 3 with both HBV and HCV) were assessed using the SCID-NP interview (Non-patients Structured Clinical Interview). Results: For the first analysis, we excluded the three patients with both HBC and HCV. Considering all diagnoses, the prevalence of psychiatric disorders was higher in HCV then in HBV patients (54% vs. 17%; p = 0.008). The difference was statistically significant even considering both diagnoses separately (p = 0.008). Considering only male subjects, differences are no longer statistically significant, but they show a trend towards significance. In particular, patients with HCV and those with HBV significantly differ as for anxiety symptoms (26% vs. 0%; p = 0.021), but not according to diagnosis of depression. Fourteen out of 60 patients (23%) presented with drug abuse; in 12 (31%), HCV was drug abuse-related (p = 0.006). Only 12.5% presented with a psychiatric diagnosis, while 67% had a past psychiatric diagnosis, and 17.1% no psychiatric diagnosis (p = 0.004). Conclusions: Our results confirm that patients with chronic HCV have a higher prevalence of psychiatric symptoms. Differences between the two groups of patients with HCV and HBV are still present when considering all symptoms (last and recent) and only recent psychiatric disorders. In our sample, there was no difference between the two groups when considering depressive disorders, while there was a statistically significant difference if only anxiety disorders are taken into consideration. All these findings are in contrast with data from literature which describe, in most cases, a higher presence of depressive symptoms in HCV patients. In our sample, drug abuse is related to past psychiatric diagnoses. A higher rate of depression in HCV patients has been explained by a psychological reaction, as a cognitive consequence of loss, after a direct action on CNS. Data from literature describe both a higher presence of psychiatric disorders in HCV patients and a higher rate of HCV among psychiatric patients. These findings render this issue of particular interest for psychiatrists and suggest the need for closer collaboration between psychiatrists and hepatologists for better managing such case