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

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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.

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Most cited references 34

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Paroxetine for the prevention of depression induced by high-dose interferon alfa.

Dominique L. Musselman, David H. Lawson, Jane Gumnick … (2001)

Depression commonly complicates treatment with the cytokine interferon alfa-2b. Laboratory animals pretreated with antidepressants have less severe depression-like symptoms after the administration of a cytokine. We sought to determine whether a similar strategy would be effective in humans. In a double-blind study of 40 patients with malignant melanoma who were eligible for high-dose interferon alfa therapy, we randomly assigned 20 patients to receive the antidepressant paroxetine and 20 to receive placebo. The treatment was begun 2 weeks before the initiation of interferon alfa and continued for the first 12 weeks of interferon alfa therapy. During the first 12 weeks of interferon alfa therapy, symptoms consistent with a diagnosis of major depression developed in 2 of 18 patients in the paroxetine group (11 percent) and 9 of 20 patients in the placebo group (45 percent) (relative risk, 0.24; 95 percent confidence interval, 0.08 to 0.93). Severe depression necessitated the discontinuation of interferon alfa before 12 weeks in 1 of the 20 patients in the paroxetine group (5 percent), as compared with 7 patients in the placebo group (35 percent) (relative risk, 0.14; 95 percent confidence interval, 0.05 to 0.85). The incidence of adverse events was similar in the two groups. In patients with malignant melanoma, pretreatment with paroxetine appears to be an effective strategy for minimizing depression induced by interferon alfa.

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Depression and immune function: central pathways to morbidity and mortality.

Janice Kiecolt-Glaser, Ronald Glaser (2002)

The increased morbidity and mortality associated with depression is substantial. In this paper, we review evidence suggesting that depression contributes to disease and death through immune dysregulation. This review focuses on recent human studies addressing the impact of depression on immune function, and the health consequences of those changes. There is growing evidence that depression can directly stimulate the production of proinflammatory cytokines that influence a spectrum of conditions associated with aging, including cardiovascular disease, osteoporosis, arthritis, type 2 diabetes, certain cancers, periodontal disease, frailty, and functional decline. Additionally, depression can down-regulate the cellular immune response; as a consequence, processes such as prolonged infection and delayed wound healing that fuel sustained proinflammatory cytokine production may be promoted by depression. These direct and indirect processes pose the greatest health risks for older adults who already show age-related increases in proinflammatory cytokine production. Thus, aging interacts with depression to enhance risks for morbidity and mortality.

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Abnormal frontal activations related to decision-making in current and former amphetamine and opiate dependent individuals.

George Lewis, P Thomas Fletcher, B. L. Clark … (2005)

There is converging evidence for impairments in decision-making in chronic substance users. In the light of findings that substance abuse is associated with disruptions of the functioning of the striato-thalamo-orbitofrontal circuits, it has been suggested that decision-making impairments are linked to frontal lobe dysfunction. We sought to investigate this possibility using functional neuroimaging. Decision-making was investigated using the Cambridge Risk Task during H2(15)O PET scans. A specific feature of the Risk Task is the decisional conflict between an unlikely high reward option and a likely low reward option. Four groups, each consisting of 15 participants, were compared: chronic amphetamine users, chronic opiate users, ex-drug users who had been long-term amphetamine/opiate users but are abstinent from all drugs of abuse for at least 1 year and healthy matched controls without a drug-taking history. During decision-making, control participants showed relatively greater activation in the right dorsolateral prefrontal cortex, whereas participants engaged in current or previous drug use showed relatively greater activation in the left orbitofrontal cortex. Our results indicate a disturbance in the mediation by the prefrontal cortex of a risky decision-making task associated with amphetamine and opiate abuse. Moreover, this disturbance was observed in a group of former drug users who had been abstinent for at least 1 year.

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Author and article information

Journal

Journal ID (nlm-ta): Hepat Mon

Journal ID (iso-abbrev): Hepat Mon

Journal ID (doi): 10.5812/hepatmon

Journal ID (publisher-id): Kowsar

Title: Hepatitis Monthly

Publisher: Kowsar

ISSN (Print): 1735-143X

ISSN (Electronic): 1735-3408

Publication date (Electronic): 06 November 2016

Publication date Collection: November 2016

Volume: 16

Issue: 11

Electronic Location Identifier: e31080

Affiliations

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

[2 ]Assistant Professor, Psychiatrist, Manager of Consultation Center, Iranian Blood Transfusion Research Center, Shiraz, IR Iran

[3 ]PhD of Immunology, Director, President, Iranian Blood Transfusion Research Center, Shiraz Blood Transfusion Organization, Shiraz, IR Iran

[4 ]Master of Cellular and Molecular Science, Shiraz, IR Iran

Author notes

[* ]Corresponding Author: Leila Kasraian, No 164 lane 37 Besat Boulevard, 7174715357 Shiraz, IR Iran. Tel: +98-9177157413, Fax: +98-7116264006, E-mail: LKasraian@ 123456yahoo.com

Article

DOI: 10.5812/hepatmon.31080

PMC ID: 5203680

SO-VID: b6cb266d-caf7-4ce5-b617-4b76e3bcd352

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

History

Date received : 07 December 2015

Date revision received : 27 July 2016

Date accepted : 05 October 2016

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

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Abstract

Background

Objectives

Methods

Results

Conclusions

Related collections

Point-Of-Care Testing for Hepatitis

Most cited references 34

Paroxetine for the prevention of depression induced by high-dose interferon alfa.

Depression and immune function: central pathways to morbidity and mortality.

Abnormal frontal activations related to decision-making in current and former amphetamine and opiate dependent individuals.

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