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The Depression Predictors among Patients with Peg-interferon Treated Hepatitis C

Ha-Na Kim, Eun-Nam Lee
Korean Journal of Adult Nursing 2014;26(2):214-222.
Published online: April 30, 2014

Department of Nursing, Dong-A University, Busan, Korea

Corresponding author: Lee, Eun Nam Department of Nursing, Dong-A University, 3 ga-1, Tongdaesin-dong, Seo-gu, Busan 602-714, Korea. Tel: +82-51-240-2864, Fax: +82-51-240-2947, E-mail: enlee@dau.ac.kr
• Received: October 30, 2013   • Accepted: February 3, 2014

© 2014 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    This study was to identify factors predicting the occurrence of depression among patients with hepatitis C treated with Peg-interferon.
  • Methods
    The subjects were 134 patients treated with Peg-interferon after the diagnosis with hepatitis C at the D University Hospital and 3 hospitals located in Busan, South Korea. The predictors of depression were identified by measuring the general characteristics of the subjects and their disease-related characteristics, social support, sleep disorders, and degree of side effects by interferon. The data were analyzed with a t-test, ANOVA, and logistic regression using the SPSS/WIN 18.0 program.
  • Results
    Sixty-six point four percent of the subjects suffered from mild to more severe depression. Fatigue, hair loss, itching, and sleep disorders turned out to be significant predictors. In addition, the explanatory power of these variables for the occurrence of depression was 70%.
  • Conclusion
    Sleep disorders and drug side effects were determined to have significant influence on the development of depression in hepatitis C patients treated with Peg-interferon. Therefore, the development of nursing intervention programs aimed to prevent depression by effectively managing sleep disorders and side effects is mandated in future to help the given population.
  • Key Words: Depression; Hepatitis; Interferons
Table 1.
Subject Classification by the BDI Score (N=134)
Classification BDI score n (%)
Normal ≤9 45(33.6)
Mild depression 10~15 39(29.1)
Moderate depression 16~23 33(24.6)
Severe depression 24~63 17(12.7)

BDI=Beck depression inventory.

Table 2.
Comparison of General Characteristics between the Depressed Group and Non-depressed Group (N=134)
Characteristics Categories Total Non-depressed group (n=45) Depressed group (n=89) x2 or t p
n (%) or M±SD n (%) or M±SD n (%) or M±SD
Age (year)   48.22±8.84 48.78±8.95 47.94±8.82 0.52 .608
Gender Male 76 (56.7) 23 (51.1) 53 (59.6) 0.87 .363
Female 58 (43.3) 22 (48.9) 36 (40.4)
Spouse Yes 118 (88.1) 40 (88.9) 78 (87.6) 1.11 .775
No 16 (11.9) 5 (11.1) 11 (12.4)
Educational level ≤High school 72 (53.7) 23 (51.1) 49 (55.1) 0.19 .665
≥College graduate 62 (46.3) 22 (48.9) 40 (44.9)
Occupation Yes 76 (56.7) 22 (48.9) 54 (60.7) 1.69 .193
No 58 (43.3) 23 (51.1) 35 (39.3)
Monthly income (10,000 won) ＜300 82 (61.2) 27 (60.0) 55 (61.8) 004 .840
≥300 52 (38.8) 18 (40.0) 34 (38.2)
Monthly medical cost (10,000 won) ＜70 39 (29.1) 19 (42.2) 20 (22.5) 5.65 .017
≥70 95 (70.9) 26 (57.8) 69 (77.5)
Alcohol† Yes 11 (8.2) 1 (0.02) 10 (11.2) 3.22 .098
No 123 (91.8) 44 (97.8) 79 (88.8)
Smoking Yes 46 (34.3) 11 (24.4) 35 (39.3) 2.94 .087
No 88 (65.7) 34 (75.6) 54 (60.7)
Family history of hepatitis Yes 41 (30.6) 15 (33.3) 26 (29.2) 0.24 .625
No 93 (69.4) 30 (66.7) 63 (70.8)

†Fisher's exact test.

Table 3.
Comparison of Disease related Characteristics between the Depressed Group and Non-depressed Group (N=134)
Characteristics Categories Total Non-depressed group (n=45) Depressed group (n=89) x2 or t p
n (%) or M±SD n (%) or M±SD n (%) or M±SD
Duration since diagnosis (year) ＜1 27 (20.1) 18 (40.0) 9 (10.1) 16.59 ＜.001
≥1 107 (79.9) 27 (40.0) 80 (89.9)
Duration since treatment (week) 1~4 34 (25.4) 25 (55.6) 9 (10.1) 32.63 ＜.001
5~12 43 (32.1) 9 (20.0) 34 (38.2)
≥13 57 (42.5) 11 (24.4) 46 (51.7)
Perceived health status compared to before treatment Improved 90 (67.2) 40 (88.9) 50 (56.2) 14.50 ＜.001
Not improved 44 (32.8) 5 (11.1) 39 (43.8)
Level of depression   13.63±7.91 5.36±2.66 17.81±6.20 -16.24 ＜.001
Level of sleep disturbance   37.37±4.14 33.13±3.82 39.45±4.65 -7.86 ＜.001
Level of social support   38.32±4.79 40.07±5.24 37.39±4.28 3.16 .002
Table 4.
Comparison of Severity of Interferon-related Side Effects between the Depressed Group and Non-depressed Group (N=134)
Variables Total Non-depressed group (n=45) Depressed group (n=89) t p
M±SD M±SD M±SD
Helplessness 4.73±3.88 3.82±3.97 5.19±3.77 -1.95 .053
Fatigue 7.18±2.57 6.40±3.06 7.57±2.21 -2.29 .025
Flu-like symptom 5.93±3.64 6.91±3.07 5.44±3.82 2.41 .018
Anorexia 2.39±3.30 0.31±1.46 3.44±3.47 -7.32 ＜.001
Weight loss 2.25±3.20 0.00±0.00 3.38±3.40 -9.38 ＜.001
Dizziness 3.37±4.07 3.18±4.18 3.47±4.03 -0.39 .698
Alopecia 3.63±4.15 1.04±2.72 4.93±4.15 -6.50 ＜.001
Itching sense 2.96±3.88 0.71±2.30 4.09±4.02 -6.17 ＜.001
Headache 2.27±3.67 1.71±3.29 2.55±3.84 -1.32 .190
Total 39.10±12.46 30.64±9.70 43.38±11.51 -6.37 ＜.001
Table 5.
Predictors of Depression by Logistic Regression (N=134)
Variables B SE Wald p OR 95% CI for OR
Lower Upper
(Constant) -19.05 3.67 26.98 ＜.001 0.00    
Fatigue 0.54 0.15 12.29 ＜.001 1.72 1.27 2.32
Alopecia 0.25 0.10 6.84 .009 1.28 1.06 1.54
Itching sense 0.37 0.11 11.44 .001 1.45 1.17 1.79
Sleep disturbance 0.40 0.08 23.72 ＜.001 1.50 1.27 1.76
Nagelkerke R2=.70; x2=94.16, df=4, p＜.001; Hit ratio=87.3%

SE=standardized error; OR=odds ratio; CI=confidence interval.

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    • Changes in Quality of Life of Chronic Hepatitis C Patients Participating in Clinical Trial
      Hoo-Jeung CHO, Euna PARK
      JOURNAL OF FISHRIES AND MARINE SCIENCES EDUCATION.2018; 30(5): 1725.     CrossRef

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    The Depression Predictors among Patients with Peg-interferon Treated Hepatitis C
    Korean J Adult Nurs. 2014;26(2):214-222.   Published online April 30, 2014
    DOI: https://doi.org/10.7475/kjan.2014.26.2.214
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    The Depression Predictors among Patients with Peg-interferon Treated Hepatitis C
    Korean J Adult Nurs. 2014;26(2):214-222.   Published online April 30, 2014
    DOI: https://doi.org/10.7475/kjan.2014.26.2.214
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    The Depression Predictors among Patients with Peg-interferon Treated Hepatitis C
    The Depression Predictors among Patients with Peg-interferon Treated Hepatitis C

    Subject Classification by the BDI Score (N=134)

    Classification BDI score n (%)
    Normal ≤9 45(33.6)
    Mild depression 10~15 39(29.1)
    Moderate depression 16~23 33(24.6)
    Severe depression 24~63 17(12.7)

    BDI=Beck depression inventory.

    Comparison of General Characteristics between the Depressed Group and Non-depressed Group (N=134)

    Characteristics Categories Total Non-depressed group (n=45) Depressed group (n=89) x2 or t p
    n (%) or M±SD n (%) or M±SD n (%) or M±SD
    Age (year)   48.22±8.84 48.78±8.95 47.94±8.82 0.52 .608
    Gender Male 76 (56.7) 23 (51.1) 53 (59.6) 0.87 .363
    Female 58 (43.3) 22 (48.9) 36 (40.4)
    Spouse Yes 118 (88.1) 40 (88.9) 78 (87.6) 1.11 .775
    No 16 (11.9) 5 (11.1) 11 (12.4)
    Educational level ≤High school 72 (53.7) 23 (51.1) 49 (55.1) 0.19 .665
    ≥College graduate 62 (46.3) 22 (48.9) 40 (44.9)
    Occupation Yes 76 (56.7) 22 (48.9) 54 (60.7) 1.69 .193
    No 58 (43.3) 23 (51.1) 35 (39.3)
    Monthly income (10,000 won) ＜300 82 (61.2) 27 (60.0) 55 (61.8) 004 .840
    ≥300 52 (38.8) 18 (40.0) 34 (38.2)
    Monthly medical cost (10,000 won) ＜70 39 (29.1) 19 (42.2) 20 (22.5) 5.65 .017
    ≥70 95 (70.9) 26 (57.8) 69 (77.5)
    Alcohol† Yes 11 (8.2) 1 (0.02) 10 (11.2) 3.22 .098
    No 123 (91.8) 44 (97.8) 79 (88.8)
    Smoking Yes 46 (34.3) 11 (24.4) 35 (39.3) 2.94 .087
    No 88 (65.7) 34 (75.6) 54 (60.7)
    Family history of hepatitis Yes 41 (30.6) 15 (33.3) 26 (29.2) 0.24 .625
    No 93 (69.4) 30 (66.7) 63 (70.8)

    †Fisher's exact test.

    Comparison of Disease related Characteristics between the Depressed Group and Non-depressed Group (N=134)

    Characteristics Categories Total Non-depressed group (n=45) Depressed group (n=89) x2 or t p
    n (%) or M±SD n (%) or M±SD n (%) or M±SD
    Duration since diagnosis (year) ＜1 27 (20.1) 18 (40.0) 9 (10.1) 16.59 ＜.001
    ≥1 107 (79.9) 27 (40.0) 80 (89.9)
    Duration since treatment (week) 1~4 34 (25.4) 25 (55.6) 9 (10.1) 32.63 ＜.001
    5~12 43 (32.1) 9 (20.0) 34 (38.2)
    ≥13 57 (42.5) 11 (24.4) 46 (51.7)
    Perceived health status compared to before treatment Improved 90 (67.2) 40 (88.9) 50 (56.2) 14.50 ＜.001
    Not improved 44 (32.8) 5 (11.1) 39 (43.8)
    Level of depression   13.63±7.91 5.36±2.66 17.81±6.20 -16.24 ＜.001
    Level of sleep disturbance   37.37±4.14 33.13±3.82 39.45±4.65 -7.86 ＜.001
    Level of social support   38.32±4.79 40.07±5.24 37.39±4.28 3.16 .002

    Comparison of Severity of Interferon-related Side Effects between the Depressed Group and Non-depressed Group (N=134)

    Variables Total Non-depressed group (n=45) Depressed group (n=89) t p
    M±SD M±SD M±SD
    Helplessness 4.73±3.88 3.82±3.97 5.19±3.77 -1.95 .053
    Fatigue 7.18±2.57 6.40±3.06 7.57±2.21 -2.29 .025
    Flu-like symptom 5.93±3.64 6.91±3.07 5.44±3.82 2.41 .018
    Anorexia 2.39±3.30 0.31±1.46 3.44±3.47 -7.32 ＜.001
    Weight loss 2.25±3.20 0.00±0.00 3.38±3.40 -9.38 ＜.001
    Dizziness 3.37±4.07 3.18±4.18 3.47±4.03 -0.39 .698
    Alopecia 3.63±4.15 1.04±2.72 4.93±4.15 -6.50 ＜.001
    Itching sense 2.96±3.88 0.71±2.30 4.09±4.02 -6.17 ＜.001
    Headache 2.27±3.67 1.71±3.29 2.55±3.84 -1.32 .190
    Total 39.10±12.46 30.64±9.70 43.38±11.51 -6.37 ＜.001

    Predictors of Depression by Logistic Regression (N=134)

    Variables B SE Wald p OR 95% CI for OR
    Lower Upper
    (Constant) -19.05 3.67 26.98 ＜.001 0.00    
    Fatigue 0.54 0.15 12.29 ＜.001 1.72 1.27 2.32
    Alopecia 0.25 0.10 6.84 .009 1.28 1.06 1.54
    Itching sense 0.37 0.11 11.44 .001 1.45 1.17 1.79
    Sleep disturbance 0.40 0.08 23.72 ＜.001 1.50 1.27 1.76
    Nagelkerke R2=.70; x2=94.16, df=4, p＜.001; Hit ratio=87.3%

    SE=standardized error; OR=odds ratio; CI=confidence interval.
    Table 1. Subject Classification by the BDI Score (N=134)

    BDI=Beck depression inventory.

    Table 2. Comparison of General Characteristics between the Depressed Group and Non-depressed Group (N=134)

    Fisher's exact test.

    Table 3. Comparison of Disease related Characteristics between the Depressed Group and Non-depressed Group (N=134)

    Table 4. Comparison of Severity of Interferon-related Side Effects between the Depressed Group and Non-depressed Group (N=134)

    Table 5. Predictors of Depression by Logistic Regression (N=134)

    SE=standardized error; OR=odds ratio; CI=confidence interval.

    Table 1.

    Table 2.

    Table 3.

    Table 4.

    Table 5.

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