Viral Hepatitis Outpatient Clinic, Instituto Alfa de Gastroenterologia, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
Department of Mental Health, School of Medicine, UFMG, Belo Horizonte, MG, Brazil.
Braz J Psychiatry. 2015 Jan-Mar;37(1):21-30. doi: 10.1590/1516-4446-2014-1446.
Patients with chronic hepatitis C (CHC) have a poorer quality of life than those with other chronic liver diseases. However, some of the factors that determine health-related quality of life (HRQOL) in these patients, such as the degree of liver fibrosis, are still controversial. Therefore, the aim of the present study was to investigate the impact of CHC on HRQOL by conducting clinical, psychiatric, and sociodemographic evaluations.
One hundred and twenty-four consecutive patients attending a referral center for hepatitis were evaluated using the Mini-International Neuropsychiatry Interview, the Hamilton Depression Rating Scale, the Hospital Anxiety and Depression Scale, and the Medical Outcomes Study 36-Item Short-Form Health Survey. Multiple linear regression analyses were used to quantify independent associations between HRQOL and the clinical, psychiatric, and sociodemographic variables of interest.
Reduced HRQOL was independently associated with major depressive disorder (MDD) and with elevated levels of alanine aminotransferase, but was not associated with hepatic cirrhosis.
MDD rather than the grade of liver fibrosis was strongly associated with HRQOL impairment in patients with CHC. These findings highlight that, in patients with CHC, the psychological effects of the disease deserve more attention and the implementation of integrated medical, psychiatric, and psychological care may be helpful.
慢性丙型肝炎（CHC）患者的生活质量较其他慢性肝病患者更差。然而，一些决定这些患者健康相关生活质量（HRQOL）的因素，如肝纤维化程度，仍存在争议。因此，本研究旨在通过临床、精神科和社会人口学评估，调查 CHC 对 HRQOL 的影响。
对 124 例就诊于肝炎转诊中心的连续患者进行了评估，使用迷你国际神经精神病学访谈、汉密尔顿抑郁评定量表、医院焦虑和抑郁量表以及医疗结局研究 36 项简明健康调查问卷。采用多元线性回归分析定量评估 HRQOL 与临床、精神科和社会人口学变量之间的独立关联。
HRQOL 降低与重性抑郁障碍（MDD）和丙氨酸氨基转移酶水平升高独立相关，但与肝硬化无关。
MDD 而非肝纤维化程度与 CHC 患者的 HRQOL 损害强烈相关。这些发现强调，在 CHC 患者中，疾病的心理影响值得更多关注，实施综合医学、精神科和心理护理可能会有所帮助。
