RESUMO
BACKGROUND: Major depressive disorder (MDD) is commonly reported in patients with chronic hepatitis C (CHC); however, the factors behind the co-occurrence of these conditions have not been completely clarified yet. OBJECTIVE: We aimed to evaluate the frequency of mental disorders in CHC patients and to investigate variables associated with MDD. METHODS: CHC patients (n=151) attending a referral Centre for hepatitis were evaluated using the Mini-International Neuropsychiatry Interview and the Cut-Annoyed-Guilty-Eye (CAGE) Questionnaire. Multivariate analysis was used to evaluate independent covariates associated with current MDD. RESULTS: Seventy-six (50.3%) patients had, at least, one current psychiatric diagnosis with MDD (33.1%) being the most common. Current MDD was independently associated with age (≤50 yr.) (OR=2.57; 95%CI=1.25-5.29; P=0.01) and type 2 diabetes mellitus (OR=2.80, 95%CI=1.17-6.70; P=0.02). Cirrhosis was associated with type 2 diabetes mellitus (OR=5.09; 95%CI=1.73-15.04; P=0.03) and current alcohol abuse/dependence (OR=2.54; 95%CI=1.04-6.22; P=0.04). DISCUSSION: MDD is associated with type 2 diabetes in CHC patients. Even in the direct-acting antivirals (DAAs) era, characterized by great perspectives for the first ample cure of a chronic viral infection, we should ensure that the screening for psychiatric disorders takes place in the course of routine clinical care of patients chronically infected with hepatitis C virus.
Assuntos
Transtorno Depressivo Maior , Diabetes Mellitus Tipo 2 , Hepatite C Crônica , Hepatite C , Antivirais/uso terapêutico , Transtorno Depressivo Maior/tratamento farmacológico , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/etiologia , Diabetes Mellitus Tipo 2/complicações , Hepatite C/tratamento farmacológico , Hepatite C Crônica/complicações , Hepatite C Crônica/tratamento farmacológico , Hepatite C Crônica/epidemiologia , HumanosRESUMO
ABSTRACT BACKGROUND: Major depressive disorder (MDD) is commonly reported in patients with chronic hepatitis C (CHC); however, the factors behind the co-occurrence of these conditions have not been completely clarified yet. OBJECTIVE: We aimed to evaluate the frequency of mental disorders in CHC patients and to investigate variables associated with MDD. METHODS: CHC patients (n=151) attending a referral Centre for hepatitis were evaluated using the Mini-International Neuropsychiatry Interview and the Cut-Annoyed-Guilty-Eye (CAGE) Questionnaire. Multivariate analysis was used to evaluate independent covariates associated with current MDD. RESULTS: Seventy-six (50.3%) patients had, at least, one current psychiatric diagnosis with MDD (33.1%) being the most common. Current MDD was independently associated with age (≤50 yr.) (OR=2.57; 95%CI=1.25-5.29; P=0.01) and type 2 diabetes mellitus (OR=2.80, 95%CI=1.17-6.70; P=0.02). Cirrhosis was associated with type 2 diabetes mellitus (OR=5.09; 95%CI=1.73-15.04; P=0.03) and current alcohol abuse/dependence (OR=2.54; 95%CI=1.04-6.22; P=0.04). DISCUSSION: MDD is associated with type 2 diabetes in CHC patients. Even in the direct-acting antivirals (DAAs) era, characterized by great perspectives for the first ample cure of a chronic viral infection, we should ensure that the screening for psychiatric disorders takes place in the course of routine clinical care of patients chronically infected with hepatitis C virus.
RESUMO CONTEXTO: O transtorno depressivo maior (TDM) é comumente detectado em pacientes com hepatite C crônica. Entretanto, fatores potencialmente associados à coocorrência destas condições não são completamente conhecidos. OBJETIVO: Avaliar a frequência de transtornos mentais em pacientes com hepatite C crônica e investigar variáveis associadas ao TDM. MÉTODOS: Pacientes com hepatite C crônica (n=151) atendidos em um centro de referência para hepatite foram avaliados usando o Mini-International Neuropsychiatry Interview e o questionário Cut-Annoyed-Guilty-Eye (CAGE). Análise multivariada foi usada para avaliar as covariáveis independentes associadas ao TDM atual. RESULTADOS: Setenta e seis (50,3%) pacientes apresentaram pelo menos um diagnóstico psiquiátrico atual; dentre eles destaca-se o TDM (33,1%). TDM atual foi independentemente associado à idade (≤50 anos) (OR=2,57; IC95% = 1,25-5,29; P=0,01) e diabetes mellitus tipo 2 (OR=2,80, IC95% = 1,17-6,70; P=0,02). Cirrose foi associada ao diabetes mellitus tipo 2 (OR=5,09; IC95% = 1,73-15,04; P=0,03) e abuso/dependência de álcool atual (OR=2,54; IC95% = 1,04-6,22; P=0,04). DISCUSSÃO: TDM está associado a diabetes tipo 2 em pacientes com hepatite C crônica. Em vigência da era dos antivirais de ação direta, caracterizada por grandes perspectivas para a primeira cura ampla de uma infecção viral crônica, devemos assegurar que a triagem dos transtornos psiquiátricos ocorra durante o atendimento clínico de rotina de pacientes com infecção crônica pelo vírus da hepatite C.