Psychiatric disorders among veterans with hepatitis C infection

Area of Science:

• Hepatology
• Psychiatry
• Infectious Diseases

Background:

• Psychiatric, drug, and alcohol use disorders may impact hepatitis C virus (HCV) management and outcomes.
• The prevalence and risk of these comorbidities in HCV patients are not well-established.

Purpose of the Study:

• To determine the frequency and risk of psychiatric, drug, and alcohol use disorders in HCV-infected veteran patients.
• To compare the prevalence of these disorders between HCV-infected and non-infected veteran populations.

Main Methods:

• A retrospective study of hospitalized veteran patients between 1992-1999.
• Inclusion of all HCV-infected patients and a control group of non-HCV patients.
• Data collection on psychiatric, drug, and alcohol use disorders from computerized medical records.

Main Results:

• 86.4% of 33,824 HCV patients had recorded psychiatric or substance use disorders; 31% had active disorders.
• HCV patients (cases) showed significantly higher rates of depression, PTSD, psychosis, bipolar disorder, anxiety, alcohol use, and drug use disorders compared to controls.
• Multivariable analyses confirmed strong associations between HCV and depression, PTSD, anxiety, alcohol use, and drug use disorders.

Conclusions:

• HCV-infected veterans exhibit a high prevalence of psychiatric and substance use disorders compared to non-infected veterans.
• A substantial proportion (at least one-third) of HCV patients present with active disorders.
• Integrated, multidisciplinary care is essential for managing HCV-infected patients with these comorbidities.