Digestive Disease Research Institute (DDRI), Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
J Psychosom Res. 2012 Sep;73(3):218-24. doi: 10.1016/j.jpsychores.2012.06.006. Epub 2012 Jul 16.
To identify independent predictors of mental and physical health in patients with viral hepatitis.
Hepatitis C (HCV) and hepatitis B (HBV) infected patients, and community control subjects with equal age and sex distribution were recruited. All subjects filled in personal characteristics questionnaire, Hospital Anxiety and Depression Scale (HADS), Iowa Fatigue Scale (IFS), and Medical Outcomes Survey Short Form-12 (SF-12). All patients had measurement of routine laboratory values, and some had recent liver biopsy. Regression analyses were used to identify predictors of physical and mental health.
One hundred eighty nine subjects (162 males, 27 females, for each group N=63) with mean (±SD) age of 39±11years were included. Anxiety and depression were important predictors of SF-12 (and its subscales MCS and PCS) and IFS scores, whereas IFS scores independently predicted HADS, PCS, MCS, and SF-12 scores. After controlling for confounders, HCV infection was independently associated with impairment of physical health. Moreover, creatinine showed an inverse strong relation with fatigue. Genotype 3a of HCV was independently associated with depressed and anxious states, whereas higher inflammation grade was significantly related to depression. Marital status, non-psychiatric comorbidities, and history of alcohol abuse also predicted health scores in the patients. Adjusted R(2)s for linear models were 0.571 to 0.709, whereas areas under the receiver operating characteristic (ROC) curve for logistic models were 0.90 to 0.93.
In viral hepatitis patients, besides mental and medical comorbidities, marital status, and alcohol abuse, HCV infection itself is associated with impaired physical and possibly mental health.
确定病毒性肝炎患者的心理和身体健康的独立预测因素。
招募丙型肝炎（HCV）和乙型肝炎（HBV）感染患者以及年龄和性别分布均等的社区对照者。所有受试者填写个人特征问卷、医院焦虑和抑郁量表（HADS）、爱荷华疲劳量表（IFS）和医疗结果调查简表 12 项（SF-12）。所有患者均进行常规实验室值检测，部分患者进行近期肝活检。回归分析用于确定身心健康的预测因素。
共纳入 189 名受试者（每组 162 名男性，27 名女性，每组 N=63），平均（±SD）年龄为 39±11 岁。焦虑和抑郁是 SF-12（及其子量表 MCS 和 PCS）和 IFS 评分的重要预测因素，而 IFS 评分独立预测 HADS、PCS、MCS 和 SF-12 评分。在控制混杂因素后，HCV 感染与身体健康受损独立相关。此外，肌酐与疲劳呈负相关。HCV 基因型 3a 与抑郁和焦虑状态独立相关，而炎症程度较高与抑郁显著相关。婚姻状况、非精神共病和酒精滥用史也预测了患者的健康评分。线性模型的调整 R(2)为 0.571 至 0.709，而逻辑模型的受试者工作特征（ROC）曲线下面积为 0.90 至 0.93。
在病毒性肝炎患者中，除了精神和医疗共病、婚姻状况和酒精滥用外，HCV 感染本身与身体和可能的心理健康受损有关。
