Srpski arhiv za celokupno lekarstvo 2015 Volume 143, Issue 1-2, Pages: 6-11
https://doi.org/10.2298/SARH1502006P
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Depressive symptoms and cognitive dysfunctions in patients with chronic hepatitis B
Pavić Slađana (General Hospital, Department for Infectious and Tropical Diseases, Užice)
Švirtlih Neda (School of Medicine, Belgrade + Clinical Center of Serbia, Clinic for Infectious and Tropical Diseases, Belgrade)
Delić Dragan (School of Medicine, Belgrade + Clinical Center of Serbia, Clinic for Infectious and Tropical Diseases, Belgrade)
Radovanović-Špurnić Aleksandra (Clinical Center of Serbia, Clinic for Infectious and Tropical Diseases, Belgrade)
Introduction. Pronounced symptoms of depression and disorders of cognitive
functions can be observed in patients with chronic hepatitis B. Objective.
The objective of the study was evaluation of the severity of symptoms and
predictive factors for depression and the existence of cognitive disorders in
patients with chronic hepatitis B. Methods. A total of 150 respondents were
included in this prospective study (50 patients with chronic hepatitis B, 50
patients with other chronic liver diseases and 50 healthy persons). The
patients with chronic hepatitis B were homogeneous by age compared to healthy
subjects (p=0.566) and patients with other chronic liver diseases (p=0.528).
Assessment of intensity of depression was determined by the Hamilton
Depression Rating Scale (HAMD). A Mini Mental State Examination (MMSE) test
was used to investigate the presence of cognitive disorders. Results.
Significantly expressed depression was observed in patients with chronic
hepatitis B compared with healthy persons as well as the occurrence of
cognitive dysfunction (p=0.00), while in comparison with the patients with
chronic nonviral liver diseases, depression was statistically significantly
less markedly expressed (p=0.003). Depression and cognitive dysfunction were
more noticeable in patients with chronic hepatitis B in the stage of liver
cirrhosis in relation to the early stage of the disease. Multivariate
analysis of variables related to the sociodemographic characteristics showed
that the most significant positive predictor of depression was more expressed
in older age (over 50 years) (B=0.276; SE=0.092; p=0.004). Conclusion.
Patients with chronic hepatitis B have a higher intensity of depression
compared to healthy people, which is intensified with the progression of the
disease. The highest expression of depression is expected in the elderly.
Patients with chronic hepatitis B have a lower intensity of depression and
fewer disorders of cognitive functions than patients with other chronic liver
diseases.
Keywords: depression, cognitive dysfunctions, chronic hepatitis B