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Depression, illness uncertainty evident in chronic HCV patients on watchful waiting

Patients with chronic hepatitis C virus on watchful waiting showed evidence of illness uncertainty and depressive symptoms; however, these were not correlated with any reassuring histological data, according to study results.

“Patients with [chronic HCV] experience illness uncertainty and depressive symptoms, with time from diagnosis being a risk factor for depressive symptoms,” the researchers wrote. “We hypothesized that reassuring histological data would decrease illness uncertainty and depressive symptoms.”

Data from 92 adult patients with chronic HCV following watchful waiting practices were collected and analyzed by researchers; the patients were deemed on watchful waiting due to the absence of antiviral treatment for HCV. Patients completed the modified Mishel Uncertainty in Illness Scale (MUIS-A) and Center for Epidemiological Studies Depression Scale (CES-D) questionnaires to determine levels of illness uncertainty and depressive symptoms.

The mean MUIS-A score was 86.45, indicating a moderate level of illness uncertainty among the patients. Fifty-four percent of patients (n=50) had illness uncertainty scores >80.

The mean CES-D score was 18.87, indicating mild to moderate depressive symptoms. Forty percent of patients (n=37) had a CES-D score of ≥16.

The MUIS-A and CES-D scores did not correlate with HCV diagnosis or fibrosis progression, according to the research. Stage of fibrosis correlated with the MUIS-A Complexity subscale; however, it did not correlate with total MUIS-A score, CES-D score or any other subscales.

Overall, the histological data did not correlate with illness uncertainty or depressive symptoms.

“We found that reassuring histological data were not correlated with less depressive symptoms and illness uncertainty in patients with [chronic HCV] on watchful waiting,” the researchers concluded. “Clinicians who advise patients to defer treatment should be aware of the possibility of the symptoms and address them.”

Disclosure: The study was supported by Harvard University and its affiliated academic health care centers.