Journal of Rawalpindi Medical College; 2019;23(S-2): 94-97 94 Original Article The Frequency of Anxiety and Depression in Patients with Hepatitis C at a Public Sector Liver Centre in Pakistan Mujtaba Haider Bukhari 1 , Ahsan Tariq 1 , Muhammad Sumeed Khalid 1 , Ali Sufyan 1 1 House Officer, RMU & Allied Hospitals Abstract Background: Co-morbid anxiety and depression are associated with hepatitis C. Co- morbid depression is associated with increased medical symptom burden, poor quality of life and poor adherence to self-care regimens. However, in Pakistan, the data assessing the psychiatric aspect of Hepatitis C is limited. Objective: The objective of this study was to evaluate the frequency of anxiety and depression in patients with Hepatitis C at a public sector liver centre in Pakistan. Methods: Participants who were positive for hepatitis C were selected by non-probability convenience sampling. Informed consent was taken verbally and a questionnaire-based interview was implied. The questionnaire scored anxiety and depression on a verified Urdu translated version of Hospital Anxiety and Depression Scale (HADS). Data was analysed with SPSS v. 22. Results: Out of 146 participants 40% were males and 60% were females with an average age of 47.2 years. Anxiety and depression were present in 47.9% and 41.8% patients of hepatitis C respectively. There was a significant association of drug use with anxiety (p=0.01) and depression (p=0.03). Urban residency was significantly associated with anxiety (p=0.04). On comparing means it was found that women had a higher average anxiety score compared to the males (10.2 ± 4.6 vs. 9.5 ± 4.6) while males had a higher average depression score compared with females (9.8 ± 4.3 vs. 9.3 ± 4.5). However, the correlation between gender and HADS scores was not significant. Conclusion: There is a high frequency of anxiety and depression among hepatitis C patients thus regular psychiatric screening, referral, treatment and follow-up is recommended. Key Words: Anxiety, Depression, Hepatitis C, Hospital Anxiety, Depression Scale Introduction It is estimated that 130 million people are affected by chronic hepatitis C infection worldwide 1 . The prevalence is as high as 16%, in some areas of Pakistan 2 . Increased medical symptoms, functional disability, medical costs, poor adherence, and increased risk of morbidity and mortality in patients with chronic medical disorders is associated with co-morbid depression 3 . According to WHO, it is the third main cause of disability-adjusted life year (DALY) 4 . Depression, being a major cause of disability; is predicted to be the second cause of disability in adults 5 . An Irish study shows 24% frequency of anxiety disorder and 28% frequency of depressive disorders among Hepatitis C patients 6 . Chinese studies report the rate of psychiatric complaints in patients with chronic liver disease as 38.1%-51.1% while a similar study in Pakistan showed a much higher frequency of depression and anxiety i.e. 71.6% and 70.6% respectively 7-9 . WHO estimates that in Pakistan the percentage of population having anxiety is 3.5% while that of depression is 4.2% 10 . The number of people with co-morbid HCV and depressive disorder (including minor depression) increased significantly between 1995 and 2005 from 18% to over 35% of all people with diagnosed HCV 11 . The above-mentioned statistics indicate that high prevalence, chronicity, complications and cirrhosis are not the only problems of Hepatitis C. The disease has a psychiatric aspect as well. Lack of education and awareness about anxiety and depression leaves this aspect of illness unaddressed. Furthermore, lack of existing medical literature in this field, especially in developing countries makes it the need of the hour to channelize research work in this direction. This study will not only quantify the existing problem in our set-up but will also provide foundations for further studies that will throw light upon this issue. Received Date: 20/2/2019 Revision Date: 23/3/2019 Accepted for Publication: 21/9/2019 brought to you by CORE View metadata, citation and similar papers at core.ac.uk provided by Journal of Rawalpindi Medical College