Viral Hepatitis
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World J Gastroenterol. Mar 14, 2006; 12(10): 1545-1550
Published online Mar 14, 2006. doi: 10.3748/wjg.v12.i10.1545
Psychological impact of chronic hepatitis C: Comparison with other stressful life events and chronic diseases
Laurent Castera, Aymery Constant, Pierre-Henri Bernard, Victor de Ledinghen, Patrice Couzigou
Laurent Castera, Victor de Ledinghen, Patrice Couzigou, Pierre-Henri Bernard, Service d’Hépato-Gastroentérologie, Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut Lévêque, 33604 Pessac, France Laurent Castera, Service d’Hépato-Gastroentérologie, Centre Hospitalier Universitaire de Bordeaux, Hôpital St-André, 33000 Bordeaux, France
Aymery Constant, Laboratoire de Psychologie de la Santé EA 3662, Université Victor Segalen Bordeaux-2, 33000 Bordeaux, France
Correspondence to: Laurent Castera, MD, Service d’Hépato-Gastroentérologie, Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut Lévêque, Avenue Magellan, 33604 Pessac, France. laurent.castera@chu-bordeaux.fr
Telephone: +33-557-656439 Fax: +33-557-656445
Received: May 4, 2005
Revised: May 15, 2005
Accepted: June 9, 2005
Published online: March 14, 2006
Abstract

AIM: To examine the psychological impact of chronic hepatitis C (CHC) diagnosis in a large cohort of CHC patients as compared with other stressful life events and chronic diseases carrying a risk of life-threatening complications.

METHODS: One hundred and eighty-five outpatients with compensated CHC were asked to self-grade, using a 100-mm visual analogue scale (VAS), the degree of stress caused by the learning of CHC diagnosis and the perceived severity of their disease. Diagnosis-related stress was compared to four other stressful life events and perceived CHC severity was compared to four other common chronic diseases.

RESULTS: Learning of CHC diagnosis was considered a major stressful event (mean ± SD scores: 72 ± 25), significantly less than death of a loved-one (89 ± 13, P < 0.0001) and divorce (78 ± 23, P < 0.007), but more than job dismissal (68 ± 30, P < 0.04) and home removal (26 ± 24, P < 0.0001). CHC was considered a severe disease (74 ± 19), after AIDS (94 ± 08, P < 0.001) and cancer (91 ± 11, P < 0.001), but before diabetes (66 ± 23, P < 0.001) and hypertension (62 ± 20, P < 0.001). Perceived CHC severity was not related to the actual severity of liver disease, assessed according to Metavir fibrosis score. In multivariate analysis, diagnosis-related stress was related to perceived disease severity (P < 0.001), trait anxiety (P < 0.001) and infection through blood transfusion (P < 0.001).

CONCLUSION: Our results show the considerable psychological and emotional burden that a diagnosis of CHC represents, even in the absence of significant liver disease. They should be taken into account when announcing a diagnosis of CHC in order to reduce its negative effects.

Keywords: Hepatitis C; Stressful life event; Perceived severity; Visual analogue scale