167570 Prevalence of depression and substance abuse in a population-based hepatitis C registry, Multnomah County, Oregon

Monday, October 27, 2008: 11:20 AM

Grace R. Van Ness, MPH, CHES , Oregon Public Health Division, Portland, OR
Atif Zaman, MD, MPH , Department of Medicine/Hepatology, Oregon Health and Science University, Portland, OR
Ann Thomas, MD MPH , Oregon Public Health Division, Portland, OR
Diata D. Rhodes, MA , Multnomah County Health Department, Portland, OR
Kathy Boaz Dhotre, MPH , Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Prevention, Centers for Disease Control and Prevention, Atlanta, GA
Stephanie R. Bialek, MD, MPH , Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Prevention, Centers for Disease Control and Prevention, Atlanta, GA
Beth P. Bell, MD, PhD , Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Prevention, Centers for Disease Control and Prevention, Atlanta, GA
Purpose: Although depression or substance abuse impacts management of persons with chronic hepatitis C infection their prevalence among those with newly reported HCV infection is not well documented. We assessed the prevalence of these disorders in persons reported to a population-based county health department hepatitis C registry.

Methods: The Multnomah County Hepatitis C Registry is a population-based surveillance system of persons testing positive for anti-HCV. During September 2005-August 2006, we selected a random sample of adults reported to the registry for an interview.

Results: Of the 2201 reports of chronic HCV infection, 891 (40%) persons were selected for participation; 195 (22%) agreed to participate. Forty-five (23%) had been tested at health department clinics/outreach sites and 116 (59%) at private medical practices. Eighty-three percent had at least a high school diploma, 65% reported an annual income <$5,000; 25% were homeless in the prior 12 months. One-hundred and twenty-one (62%) reported a history of or treatment for depression or other mental health issues. Of 84 enrollees who completed the Beck Depression Inventory, 25 (30%) met the criteria for current major depressive disorder. Forty-six (27%) reported current alcohol use. Sixty (31%) reported illicit drug use in the prior year; of these, 68% had injected drugs.

Conclusions: Depression and substance abuse were highly prevalent among persons with chronic HCV infection identified in a public health registry. These findings highlight the importance of addressing social issues that impact the medical management of HCV infection for a substantial proportion of persons with the infection.

Learning Objectives:
1. List common risk factors associated with HCV transmission. 2. Discuss prevalence of mental health disorders and substance abuse in persons with newly-reported HCV infection. 3. Discuss how mental health disorders and substance abuse impacts medical management of HCV infection.

Keywords: Hepatitis C, Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was involved in study design and the development of data collection instruments. In addition, I serve as local project coordinator for this study. My role in the study is to maintain the Multnomah County hepatitis C registry, track enrollment and conduct other data analysis projects, obtain physician authorization to contact patients, contact patients, and serve as a secondary patient interviewer.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Infectious Disease Epidemiology
See more of: Epidemiology