Modabbernia Amirhossein, Poustchi Hossein, Malekzadeh Reza
Digestive Disease Research Centre, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran ; Psychiatric Research Centre, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.
Hepat Mon. 2013 Jan;13(1):e8340. doi: 10.5812/hepatmon.8340. Epub 2013 Jan 7.
We briefly reviewed the evidence on the association of hepatitis C (HCV) infection with several aspects of mental and psychosocial health.
Medline was searched with appropriate keywords. The primary sources were the systematic reviews. If systematic reviews were not available for a subject, then the most relevant and methodologically sound original studies were selected.
HCV infection is associated with poorer health-related quality of life, and physical, mental, and social health. A part of impaired health of these patients is related to cirrhosis, intravenous drug use, co morbid psychiatric disorders, stigmatization, poor social support, alcohol abuse, and interferon treatment. However, HCV itself is also associated with poorer health status particularly in the physical and cognitive domains, which might be related to brain alterations induced by the virus. Interferon treatment is an important cause of depression in HCV patients and sometimes is associated with irritability, manic episode, or acute confusional state. Social health of HCV patients is significantly impaired by stigmatization, poor social support, psychiatric comorbidties, and impaired coping. Psychosocial impairment of HCV patients significantly impairs their treatment adherence. A supportive and nonjudgmental multidisciplinary team is required for optimal management of these patients.
Patients with HCV infection had complex neuropsychiatric and psychosocial problems. These problems are challenges for management of HCV infection, affect the patient's care significantly, and might alter the course of the disease. A multidisciplinary approach, a supportive environment, and a nonjudgmental healthcare team are required for optimal medical and psychosocial management of patients with HCV.
我们简要回顾了丙型肝炎（HCV）感染与精神和心理社会健康若干方面关联的证据。
使用适当关键词检索了医学文献数据库（Medline）。主要来源是系统评价。如果某一主题没有系统评价，则选择最相关且方法学合理的原始研究。
HCV感染与较差的健康相关生活质量以及身体、心理和社会健康相关。这些患者健康受损的部分原因与肝硬化、静脉吸毒、共病精神障碍、污名化、社会支持不足、酗酒和干扰素治疗有关。然而，HCV本身也与较差的健康状况相关，尤其是在身体和认知领域，这可能与病毒引起的脑部改变有关。干扰素治疗是HCV患者抑郁的重要原因，有时还与易怒、躁狂发作或急性意识模糊状态有关。污名化、社会支持不足、精神共病和应对能力受损显著损害了HCV患者的社会健康。HCV患者的心理社会损害显著损害了他们的治疗依从性。最佳管理这些患者需要一个支持性且不评判的多学科团队。
HCV感染患者存在复杂的神经精神和心理社会问题。这些问题是HCV感染管理的挑战，对患者护理有重大影响，可能改变疾病进程。HCV患者的最佳医疗和心理社会管理需要多学科方法、支持性环境和不评判的医疗团队。
