Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Arch Iran Med. 2013 Feb;16(2):114-22.
Psychosocial issues and health-related quality of life (HRQOL) are important components of care in patients diagnosed with chronic hepatitis B (CHBV). In this review, we searched Medline, ISI Web of Knowledge, Google Scholar and the American Association for the Study of Liver Diseases (AASLD) website (until January 2012) using relevant terms and we categorized the retrieved content into three areas: HRQOL, mental health, and psychosocial issues such as stigma and coping. Increasing severity of CHBV leads to a decline in HRQOL. Cirrhosis worsens HRQOL, whereas treatment and psycho-education improves it. Frequency of mood disorders seems to be increased in patients with CHBV, although not all studies have shown this trend. Some factors such as alcohol consumption and low social support negatively impact patients' mental health. Those with CHBV generally have better HRQOL and mental health than their hepatitis C (HCV) counterparts. Patients with psychiatric disorders, particularly those with prolonged institutionalization, have a generally higher risk of acquiring CHBV infection compared to the general population. Robust studies regarding the stigma in patients with CHBV are lacking, although some studies have suggested a higher degree of perceived stigma in these patients. HRQOL and mental health are significantly affected in CHBV patients, particularly in those with more severe forms of the disease. There are few studies that addressed the effects of intervention in CHBV patients with psychosocial problems. Other subjects necessitating additional research include stigma, coping mechanisms, and other less common, yet important psychosomatic disorders.
心理社会问题和健康相关生活质量（HRQOL）是慢性乙型肝炎（CHBV）患者护理的重要组成部分。在这篇综述中，我们使用相关术语在 Medline、ISI Web of Knowledge、Google Scholar 和美国肝病研究协会（AASLD）网站（截至 2012 年 1 月）进行了检索，并将检索到的内容分为三个领域：HRQOL、心理健康和耻辱感和应对等心理社会问题。CHBV 严重程度的增加会导致 HRQOL 下降。肝硬化会使 HRQOL 恶化，而治疗和心理教育则会改善它。CHBV 患者出现情绪障碍的频率似乎增加，尽管并非所有研究都显示出这种趋势。一些因素，如饮酒和低社会支持，会对患者的心理健康产生负面影响。与丙型肝炎（HCV）患者相比，一般来说，CHBV 患者的 HRQOL 和心理健康状况更好。患有精神疾病的患者，特别是那些长期住院的患者，与一般人群相比，感染 CHBV 的风险通常更高。虽然一些研究表明这些患者的感知耻辱感更高，但缺乏针对 CHBV 患者耻辱感的有力研究。CHBV 患者的 HRQOL 和心理健康受到显著影响，特别是在那些病情更严重的患者中。关于有心理社会问题的 CHBV 患者干预效果的研究较少。其他需要进一步研究的课题包括耻辱感、应对机制以及其他不那么常见但同样重要的身心障碍。
