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Psychopathological changes and quality of life in hepatitis C virus‐infected, opioid‐dependent patients during maintenance therapy
Author(s) -
Schäfer Arne,
Wittchen HansUlrich,
Backmund Markus,
Soyka Michael,
Gölz Jörg,
Siegert Jens,
Schäfer Martin,
Tretter Felix,
Kraus Michael R.
Publication year - 2009
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/j.1360-0443.2009.02509.x
Subject(s) - medicine , psychopathology , tolerability , hepatitis c , methadone , quality of life (healthcare) , hepatitis c virus , cohort study , cohort , psychiatry , immunology , adverse effect , virus , nursing
Aims To examine among maintenance patients (methadone or buprenorphine) with and without hepatitis C virus (HCV) infection (i) the frequency of psychopathological symptoms at baseline and 1‐year follow‐up; (ii) the association between antiviral interferon (IFN) treatment and psychopathological symptoms; and (iii) to explore whether IFN therapy has an effect on 1‐year outcome of maintenance treatment. Design Naturalistic prospective longitudinal cohort design. Setting A total of 223 substitution centres in Germany. Participants A nationally representative sample of 2414 maintenance patients, namely 800 without and 1614 with HCV infection, of whom 122 received IFN therapy. Measures HCV infection (HCV + /HCV ‐ ), IFN (IFN + /IFN ‐ ) treatment status and clinical measures. Diagnostic status and severity (rated by clinician), psychopathology (BSI—Brief Symptom Inventory) and quality of life (EQ‐5D—EuroQol Group questionnaire). Findings HCV + patients revealed indications for a moderately increased psychopathological burden and poorer quality of life at baseline and follow‐up compared to HCV ‐ patients. HCV + patients showed a marked deterioration over time only in the BSI subscale somatization ( P = 0.002), and the frequency of sleep disorders almost doubled over time (12.8% at baseline; 24.1% at follow‐up; P < 0.01). IFN treatment, received by 10% of HCV + patients, did not impair efficacy or tolerability of maintenance therapy and was associated overall with neither increased psychopathological burden nor reduced quality of life. Conclusions Findings suggest no increased risk among HCV + patients on maintenance therapy for depressive or other psychopathological syndromes. In our patient sample, IFN treatment was not associated with increased psychopathological burden, reduced quality of life or poorer tolerability and efficacy of maintenance treatment.