Yilmaz Ahmet, Ucmak Feyzullah, Dönmezdil Süleyman, Kaya Mehmet Cemal, Tekin Recep, Günes Mehmet, Arslan Necmi, Bulut Mahmut
From the Department of Family Medicine (AY, NA), Dicle University Medical Faculty, Diyarbakir, Turkey; Medical Faculty (FU), Department of Gastroenterology, University of California, San Francisco, San Francisco, CA, Department of Psychiatry (SD), Selahaddin Eyyubi State Hospital; Department of Psychiatry (MCK, MB, MG), Dicle University Medical Faculty; and Department of Infectious Diseases (RT), Dicle University Medical Faculty, Diyarbakir, Turkey.
Medicine (Baltimore). 2016 May;95(21):e3779. doi: 10.1097/MD.0000000000003779.
In the present study, we aimed to determine the differences in body image along with anxiety and depression levels, and also to evaluate their impact on disability parameters in patients with hepatitis B.Our study comprised 77 patients with hepatitis B (n = 41, chronic active patients; n = 36, patients with inactive hepatitis B) and 53 healthy individuals (control group). Enrolled patients responded to several questionnaires, including a sociodemographic form, Sheehan Disability Scale (SDS), Hospital Anxiety and Depression Scale (HADS), and Somatosensory Amplification Scale.Patients with chronic active hepatitis B (CAHB) had higher levels of somatosensory perception than patients with inactive hepatitis B (IHB) and control group (P < 0.001, P = 0.001, respectively). Patients with CAHB had high scores on all the 3 domains of SDS (work/school, P < 0.001; social life, P < 0.001; and family life, P < 0.001). Also, patients with CAHB had a significantly higher HADS total score, HADS anxiety score, and HADS depression score than control group (P < 0.001, P < 0.001, P < 0.001, respectively). No significant difference was noted between patients with CAHB and patients with IHB with regard to HADS depression score; however, HADS anxiety and HADS total scores were significantly higher in the CAHB group (NS, P = 0.027, P = 0.035, respectively). Moreover, the IHB group exhibited higher scores for the work/school and social life domains of SDS than those of the control group (P = 0.008, P = 0.047).Although patients with CAHB may present with somatosensory amplification, anxiety, and depression, patients with IHB do not exhibit such symptoms. However, functionality is affected in both carrier and active patient groups. We believe that routine health checks of patients with hepatitis B should include psychiatric evaluation, psychiatric examination, and follow-up.
在本研究中，我们旨在确定乙肝患者身体意象与焦虑和抑郁水平的差异，并评估它们对残疾参数的影响。我们的研究包括77例乙肝患者（n = 41，慢性活动期患者；n = 36，非活动性乙肝患者）和53名健康个体（对照组）。入选患者回答了几份问卷，包括一份社会人口学表格、希恩残疾量表（SDS）、医院焦虑抑郁量表（HADS）和躯体感觉放大量表。慢性活动期乙肝（CAHB）患者的躯体感觉知觉水平高于非活动性乙肝（IHB）患者和对照组（分别为P < 0.001，P = 0.001）。CAHB患者在SDS的所有3个领域得分都很高（工作/学习，P < 0.001；社会生活，P < 0.001；家庭生活，P < 0.001）。此外，CAHB患者的HADS总分、HADS焦虑得分和HADS抑郁得分显著高于对照组（分别为P < 0.001，P < 0.001，P < 0.001）。CAHB患者和IHB患者在HADS抑郁得分方面无显著差异；然而，CAHB组的HADS焦虑得分和HADS总分显著更高（无显著性差异，P = 0.027，P = 0.035）。此外，IHB组在SDS的工作/学习和社会生活领域的得分高于对照组（P = 0.008，P = 0.047）。虽然CAHB患者可能表现出躯体感觉放大、焦虑和抑郁，但IHB患者没有这些症状。然而，携带者和活动期患者组的功能都受到了影响。我们认为，乙肝患者的常规健康检查应包括精神评估、精神检查和随访。
