Physiological and Subjective Responses after Psychosocial Stress in Chinese Hepatitis B Patients

Abstract

Compared with healthy participants, Chinese patients with hepatitis B (HB) experience more psychosocial stress. The present study provided the first examination of physiological and subjective responses to stress in Chinese HB patients. A standard psychosocial stressor, the Trier Social Stress Test (TSST), was administered to 26 Chinese HB patients and 24 healthy control participants. Cortisol concentrations were measured in blood samples collected before and after the stressor. Self-reported emotional responses and cardiovascular measures were examined before and after the TSST. Depression and anxiety were assessed using Hospital Anxiety and Depression Scale. Chinese HB patients exhibited higher cortisol response to the stressor than healthy control participants. Compared with healthy participants, Chinese HB patients showed higher levels of anxiety, depression and nervousness, and lower levels of calmness after the TSST. HB patients reported more negative life events in the previous 6 months and obtained higher adversity scores, as compared with control participants. Significant correlations were obtained between adversity scores and change cortisol secretion after TSST in HB patients, but not in healthy participants. This study firstly demonstrates that physiological and subjective responses to psychosocial stress among Chinese HB patients were different from that in healthy control participants.

Development of Self-Management Indicators for Chronic Hepatitis B Patients on Antiviral Therapy: Results of a Chinese Delphi Panel Survey

“…Compared with healthy participants, CHB patients in China frequently faced discrimination in all aspects of life and work, and experienced more psychosocial stress [ 34 ]. Psychosocial management was recognized as an important part of self-management for patients with chronic diseases.…”

Hepatitis B-Related Concerns and Anxieties Among People With Chronic Hepatitis B in Australia

“…In one study among people with CHB, having hepatitis B-related concerns were associated with the presence of major depression (3). In another study, people with CHB exhibited higher cortisol response to a standardized psychosocial stressor, and also higher levels of anxiety and depression after the stressor than people without CHB, suggesting a higher sensitivity to the psychological stress and greater distress in this population (2). …”

“…cirrhosis and liver cancer), social marginalisation, and possible stigma associated with an infection that can be transmitted sexually. There are several reports of poorer psychosocial health including increased prevalence of anxiety and depression (2-5) and impaired quality of life (6-10) among people with CHB, while people with more advanced liver disease showed greater impairment of their quality of life (11, 12). Therefore, an exclusive focus on liver health and the biological outcomes of CHB underestimates the true individual burden of the infection.…”