Depression in patients with chronic hepatitis B and cirrhosis is closely associated with the severity of liver cirrhosis

Abstract

Abstract. Depression in patients with chronic hepatitis B (CHB) can affect the quality of life, disease diagnosis and case fatality rate. The aim of this study was to explore depression in patients with CHB and cirrhosis, and the effect of the severity of liver cirrhosis on the depressive emotional state. The depressive emotional state was investigated using the Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) in 114 patients with CHB and cirrhosis, comprising 42 cases classified as Child-Pugh grade (CPG)-A, 38 cases classified as CPG-B and 34 cases classified as CPG-C at a single hepatology center. Patients with mood disorders accounted for 33.33% of the 114 cases with CHB and liver cirrhosis and comprised 10 cases of CPG-A, 12 cases of CPG-B and 16 cases of CPG-C classification. The results shows that HAMA and HAMD scores of patients in the CPG-C group were significantly higher than those in the CPG-A group (P<0.01), but not significantly higher than those in the CPG-B group (P>0.05). The incidence rate of mood disorders in the CPG-C group was significantly higher than that in the CPG-B group (P=0.0336), and the incidence rate of mood disorders was higher in the CPG-B group compared with the CPG-A group, but the difference was not statistically significant (P= 0.4370). The incidence rate of mood disorders in patients in the CPG-A group was significantly lower than that in the CPG-C group (P=0.0078). The study shows that a considerable proportion of patients with liver cirrhosis have mood disorders, and the depression rates of CHB-infected patients with liver cirrhosis are closely associated with the severity of the cirrhosis.

Nonliver Comorbidities in Patients With Chronic Hepatitis B

“…Interestingly, patients receiving treatment for CHB did not convey an increased risk for bipolar disorder. In a related study, Zhu et al found that the higher the Child‐Pugh rating, the higher patients scored on two widely used depression and anxiety scales (Hamilton Depression Scale and Hamilton Anxiety Scale). In another China‐based study, controlled for socioeconomic factors, awareness of having hepatitis B increased odds of major depression (OR 1.84 [95% CI: 1.16‐2.90]) compared with patients without hepatitis B .…”

Psychological distress and self‐management behaviours among patients with chronic hepatitis B receiving oral antiviral therapy

“…Like patients with other chronic diseases (Katon, 2011), patients with CHB often experience different degrees of psychological distress, such as depression and anxiety. It was reported that the prevalence of depressive symptoms in patients with CHB varied from 16–40.6% (Chan et al., 2012; Keskin et al., 2013; Zhu et al., 2016) and that of anxiety symptoms from 6.7–48.7% (Chan et al., 2012; Vu et al., 2019; Yilmaz et al., 2016) based on different measurements.…”

The Effectiveness of Cognitive Behavioral Group Therapy on Depression, Hope and Adjustment in Patients with Hepatitis B

“…Nevertheless, to faster improve depression, using the techniques of other therapeutic approaches including the third wave of cognitive behavior therapies combined with cognitive behavior group therapy may be needed. Furthermore, in patients with hepatitis B-associated liver cirrhosis, depression is closely associated with the severity of the cirrhosis [72]. To investigate these instances, extensive research in the future is required.…”