Grassi Luigi, Satriano James, Serra Alessia, Biancosino Bruno, Zotos Spyridon, Sighinolfi Laura, Ghinelli Florio
Department of Medical Sciences of Communication and Behavior, Section of Psychiatry, University of Ferrara, Italy.
Psychother Psychosom. 2002 Nov-Dec;71(6):342-9. doi: 10.1159/000065993.
The increasing health problem of hepatitis C virus (HCV) infection has only recently attracted the attention of psychosocial research, especially among subjects at higher risk (e.g. intravenous drug users; IDUs). The aim of the present study was to compare emotional stress symptoms, psychosocial variables (i.e. social support, external locus of control and emotional repression) and coping strategies in HCV-seropositive, human immunodeficiency virus (HIV)-seropositive and HCV/HIV-noninfected IDUs.
IDUs followed by the Infectious Diseases Outpatient clinic were enrolled in the study over a period of 1 year. HCV-positive (n = 62) and HIV-positive (n = 76) IDUs and HCV/HIV-seronegative IDUs (n = 152) completed the Brief Symptom Inventory, the Social Provision Scale, the Locus of Control scale and the affective inhibition scale of the Illness Behavior Questionnaire. Coping with illness among HCV-positive and HIV-positive subjects was assessed through a modified version of the Mental Adjustment to Cancer Scale.
No significant differences were found between the samples with respect to individual and interpersonal variables. HCV-positive subjects showed higher scores on several psychological stress dimensions (i.e. obsessive-compulsive, phobic anxiety, paranoid ideation, psychoticism) and lower scores on fighting spirit, hopelessness and anxious preoccupation towards illness than HIV-positive patients. HCV-positive and HCV/HIV-seronegative IDUs reported comparable scores on most of the psychological measures.
The findings indicate that routine assessment of psychosocial variables and coping mechanisms should be integrated into all HCV and HIV services, especially those dedicated to treatment of patients with substance abuse, as a vulnerable segment of the population at risk for life-threatening physical illness such as HCV and HIV infections.
丙型肝炎病毒（HCV）感染日益严重的健康问题直到最近才引起社会心理研究的关注，尤其是在高危人群（如静脉吸毒者）中。本研究的目的是比较HCV血清阳性、人类免疫缺陷病毒（HIV）血清阳性以及HCV/HIV未感染的静脉吸毒者的情绪应激症状、社会心理变量（即社会支持、外控 locus和情绪压抑）及应对策略。
在1年的时间里，招募了传染病门诊随访的静脉吸毒者参与研究。HCV阳性（n = 62）和HIV阳性（n = 76）的静脉吸毒者以及HCV/HIV血清阴性的静脉吸毒者（n = 152）完成了简明症状量表、社会支持量表、控制源量表以及疾病行为问卷的情感抑制量表。通过对癌症心理调适量表的修订版来评估HCV阳性和HIV阳性受试者应对疾病的情况。
在个体和人际变量方面，各样本之间未发现显著差异。与HIV阳性患者相比，HCV阳性受试者在几个心理应激维度上得分更高（即强迫观念、恐惧焦虑、偏执观念、精神质），而在斗志、绝望感以及对疾病的焦虑关注方面得分更低。HCV阳性和HCV/HIV血清阴性的静脉吸毒者在大多数心理测量指标上得分相当。
研究结果表明，应将社会心理变量和应对机制的常规评估纳入所有HCV和HIV服务中，尤其是那些致力于治疗药物滥用患者的服务，因为这部分人群作为易感染HCV和HIV感染等危及生命的身体疾病的高危群体较为脆弱。
