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设拉子丙型肝炎献血者中抑郁症患病率的调查

A Survey on the Prevalence of Depression in Blood Donors with Hepatitis C in Shiraz.

作者信息

Kasraian Leila, Negarestani Neda, Karimi Mohammad Hossein, Dehbidi Sahar

机构信息

Associate Professor, Community Medicine Specialist, Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Shiraz, IR Iran.

Assistant Professor, Psychiatrist, Manager of Consultation Center, Iranian Blood Transfusion Research Center, Shiraz, IR Iran.

出版信息

Hepat Mon. 2016 Nov 6;16(11):e31080. doi: 10.5812/hepatmon.31080. eCollection 2016 Nov.

Abstract

BACKGROUND

Depression is the most common psychiatric disorder associated with hepatitis C.

OBJECTIVES

This study aimed to survey the prevalence rate of depression in patients with Hepatitis C Virus (HCV) before they were aware of their HCV test result.

METHODS

This cross-sectional study was conducted on all blood donors with confirmed positive HCV test results who donated blood between March 21, 2012 to March 21, 2013 at Fars blood transfusion center in Iran as case group and age- and sex-matched blood donors with negative screening test results as control group. A semi-structured interview based on DSM IV-TR depressive disorder criteria and Beck depression inventory (BDI) was conducted. BDI contained 21 items, each scored from 0 to 3 and total score of 0 to 63 for the whole scale computed by summing up all the items. A cut-off score of ≥ 19 indicated clinically significant depressive symptoms. The prevalence rate and risk factors of depression were determined.

RESULTS

The most frequent risk factors for HCV infection were intravenous drug abuse (59.3%), unsafe sexual contact (30.5%), and history of being imprisoned (25.4%). The prevalence rate of depression in the HCV group was 55.9 % (95% CI: 42.99% - 68.87%) that was significantly higher than the corresponding rate of the control group as 17.7 % ( 95% CI: 8.49% - 28.79%) (P < 0.001). The severity of depression was also more in the HCV group (P < 0.001). Besides, the prevalence rate of depression was higher among HCV patients with lower education level, previous history of drug abuse, unsafe sexual contact, and previous history of psychiatric diseases. The prevalence rate of depression was higher in the case group even after adjusting for other variables.

CONCLUSIONS

Our study underlined the remarkable prevalence of depression among HCV patients. Therefore, designing depression screening tests is suggested to help such patients before starting the treatment.

摘要

背景

抑郁症是与丙型肝炎相关的最常见精神障碍。

目的

本研究旨在调查丙型肝炎病毒(HCV)感染者在知晓其HCV检测结果之前的抑郁症患病率。

方法

本横断面研究以2012年3月21日至2013年3月21日期间在伊朗法尔斯输血中心献血且HCV检测结果确诊为阳性的所有献血者为病例组,以年龄和性别匹配且筛查检测结果为阴性的献血者为对照组。基于《精神疾病诊断与统计手册》第四版修订版(DSM IV-TR)抑郁症标准和贝克抑郁量表(BDI)进行半结构式访谈。BDI包含21个项目,每个项目的评分从0到3,通过对所有项目求和计算出整个量表的总分在0到63之间。截断分数≥19表明存在具有临床意义的抑郁症状。确定抑郁症的患病率和危险因素。

结果

HCV感染最常见的危险因素是静脉注射吸毒(59.3%)、不安全的性接触(30.5%)和有监禁史(25.4%)。HCV组抑郁症的患病率为55.9%(95%可信区间:42.99% - 68.87%),显著高于对照组的相应患病率17.7%(95%可信区间:8.49% - 28.79%)(P < 0.001)。HCV组的抑郁严重程度也更高(P < 0.001)。此外,教育水平较低、有药物滥用史、不安全的性接触史和有精神疾病史的HCV患者中抑郁症的患病率更高。即使在对其他变量进行调整后,病例组中抑郁症的患病率仍较高。

结论

我们的研究强调了HCV患者中抑郁症的显著患病率。因此,建议设计抑郁症筛查测试,以便在开始治疗前帮助此类患者。

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Barriers to accessing care in patients with chronic hepatitis C: the impact of depression.慢性丙型肝炎患者获得治疗的障碍:抑郁的影响。
Aliment Pharmacol Ther. 2010 Nov;32(9):1163-73. doi: 10.1111/j.1365-2036.2010.04460.x. Epub 2010 Sep 17.
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Managing depression during hepatitis C treatment.丙型肝炎治疗期间的抑郁症管理
Can J Psychiatry. 2009 Sep;54(9):614-25. doi: 10.1177/070674370905400906.

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