Somatization among Compensated Hepatitis C Virus Patients

Background: Egypt has a population of more than 80 million and contains the highest prevalence of hepatitis C in the world. The national prevalence rate of hepatitis C Virus (HCV) antibody positivity has been estimated to be between 10-13%. The estimated adjusted national prevalence rate of chronic hepatitis C infection is 7.8% or 5.3 million people in 2004. Neuropsychiatric symptoms have been reported in association with both hepatitis C and α interferon (IFN-α) treatment. Objectives: To assess somatization among compensated hepatitis C virus patients within one year of diagnosis Methods: In the current cross sectional controlled study, a selective sample of 48 compensated hepatitis C virus patients and their matched controls were interviewed using the Symptom Checklist (SCL-12-R) to determine the presence and severity of somatic symptoms. Patients were also interviewed to assess anxiety and depression using Hamilton anxiety rating scale and Hamilton rating scale for depression. Before that, patients had been examined by hepatologist in hepatitis outpatient clinic of El-Mataria Teaching Hospital to determine the hepatic status of all patients and that the condition is newly diagnosed and is compensated. Results: Somatization was more common among patients (33.3%) compared the healthy control subjects (16.7%); p=0.059. Headache, fatigue, chest pain, low back pain, nausea, muscle ache, difficulty in breathing, hot and cold flushes, numbness/tingling, difficulty in swallowing and limb weakness were the more frequent symptoms mainly among HCV patients with statistically significant difference; except for chest pain. However, body weakness was less frequent in both groups. Hamilton’s rating score for depression was statistically significantly higher among HCV patients than control subjects (mean; 21.5±8.7 vs. 15.4± 8.7, p=0.001). Hamilton’s rating score for anxiety among HCV patients was also statistically significantly higher than control subjects (mean; 18.4 ± 10.6 vs. 12.3 ± 9.5; p=0.004). Conclusion: Patients with viral hepatitis C had a higher rate and severity of somatization compared to normal controls. Special attention should be paid to active participation of consultation-liaison psychiatry in the management plan of chronic viral hepatitis C.