186013 Depression Changes in Hepatitis C Patients Undergoing Antiviral Therapy

Tuesday, October 28, 2008: 3:20 PM

Kelly M. Simpson, MA , Department of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, NC
Amit Verma, MPH , Department of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, NC
Donna M. Evon, PhD , Department of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, NC
Karen A. Dougherty, ANP , Department of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, NC
Michael W. Fried, MD , Department of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, NC
Background:

Hepatitis C viral infection (HCV) has a prevalence rate 5 times greater than HIV infection. Current treatment eradicates HCV in 40%-80% of cases. However, depression is common on treatment, and may be negatively associated with treatment outcomes.

Aims:

To determine depression changes during the first 6 months of treatment, and identify risk factors associated with increased depression on treatment.

Methods:

Medical records of 180 HCV patients, treated from 2002-2006, were reviewed. Patients completed the Center for Epidemiological Studies-Depression Inventory (CES-D). Baseline factors included: age, gender, race, and history of substance abuse, depression, anxiety, irritability. Associations between peak change (Δ) in CES-D scores, the difference from baseline to highest CES-D score on treatment, and baseline factors were assessed.

Results:

Patients were male (59%), Caucasian (80%), and on average 45 years old. Baseline CES-D scores (x=10.7;range=0-37) indicated no depression. Scores peaked during weeks 6-8 (x=16;range= 0-52) and indicated 38%, 20%, and 42% of patients experienced no, mild, and severe depression, respectively. Significant associations existed between Δ scores and Hx of depression (p<.0005), anxiety (p<.0001). Ten patients (6%) were discontinued due to depression (x= week 5;range 2-16 weeks). Their baseline CES-D scores (x=19;range= 6-37) started in the mildly depressed range, and peak CES-D scores (x=37.14;range= 8-52) occurred between week 6-8. Eighty percent of these patients fell into the severely depression range.

Conclusions:

In order to improve health outcomes and reduce the burden of HCV, it will be critical to effectively manage the psychiatric needs of HCV patients undergoing antiviral treatment.

Learning Objectives:
1) Increase understanding about HCV and common depression that occurs during antiviral treatment. 2) Improve understanding of the association between pre-existing psychiatric symptoms and the likelihood of developing psychiatric symptoms during treatment

Keywords: Depression, Hepatitis C

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a PhD Candidate in Public Health, and I have several years of public health research experience. I am recently published (in press) on other research questions answered out of the same data used to produce this abstract. I am a project coordinator currently for a protocol working with Hepatitis C patients in the Department of Hepatology at UNC-Chapel Hill.
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: Psychiatric Epidemiology
See more of: Epidemiology