Study Identifies Areas for Mental Health Intervention for Patients with HCV
Treatment for the hepatitis C virus (HCV) is lengthy, rigorous, and is associated with side effects that are difficult to manage. In addition to physiological side effects, there also can be significant neuropsychiatric effects such as depression, anxiety, psychosis, and suicidality. Moreover, numerous studies have documented the high prevalence of pre-existing psychiatric disorders among patients with HCV: approximately 27-78% of this patient population has been diagnosed with current or past substance abuse, 15-62% with mood disorders, and 30-40% with anxiety disorders. Therefore, increased attention is being paid to the potential usefulness of integrating psychiatric services with standard medical care for patients with HCV.
This article reviews the psychological and psychosocial issues that are relevant to patients with HCV and provides mental health treatment recommendations. Some of these issues include stigma (i.e., more than half diagnosed with HCV have experienced discrimination) and social support. The authors also identify areas in which clinicians can intervene, including adjustment to having a chronic medical illness, management of side effects, and implementing healthy lifestyle recommendations. For example, active drinking accelerates HCV-related liver damage and decreases the effectiveness of drug therapy, and smoking can lead to more rapid progression of the HCV infection. Mental health clinicians should be aware of the challenges inherent in these areas so that they may adequately support patients diagnosed with HCV, as well as those receiving treatment.
Silberbogen A, Ulloa E, Janke E, and Mori D. Psychosocial issues and mental health treatment recommendations for patients with hepatitis C. Psychosomatics Mar-April 2009;50(2):114-22.
This study was funded by VA. Dr. Janke is part of HSR&D's Center for the Management of Complex Chronic Care in Hines, IL.