The Use of Psychoeducation for a Patient with Hepatitis C and Psychiatric Illness in Preparation for Antiviral Therapy: A Case Report and Discussion

  • Barry A. Hong
  • Carol S. North
  • David E. Pollio
  • Anna Abbacchi
  • Christine Debold
  • Sunday A. Adewuyi
  • Mauricio Lisker-Melman
Case Report

DOI: 10.1007/s10880-011-9227-6

Cite this article as:
Hong, B.A., North, C.S., Pollio, D.E. et al. J Clin Psychol Med Settings (2011) 18: 99. doi:10.1007/s10880-011-9227-6

Abstract

The standard of care treatment for chronic hepatitis C viral infection (HCV) is a combination of pegylated interferon alfa and ribavirin for 24–48 weeks according to the virus genotype. This therapy is known to have multiple neuropsychiatric side effects. A major concern when evaluating a patient for HCV treatment with a known history of a psychiatric disorder is the risk that the patient’s psychiatric disorder will flare or become unmanageable. The possibility of precipitating depression, confusion, mania, psychosis, hallucinations, or suicidal ideation or attempt is frequently an obstacle to treatment. We present the case of a 50 year-old man with HCV and an extensive psychiatric history involving alcoholism, depression, and suicidality who participated in a psychoeducation group to help prepare him for treatment with pegylated interferon alfa/ribavirin therapy. Though the patient derived much benefit from the psychoeducation group, by the time of evaluation for HCV treatment two months after the group ended he had relapsed back into a depressive episode with suicidal thoughts. His acute psychiatric status made him unacceptable for pegylated interferon alfa/ribavirin therapy. Psychoeducation groups show promise for helping patients with chronic medical illness to be ready for and endure intensive medical treatment that has substantial psychiatric side effects. The challenge is to help patients overcome barriers to treatment, particularly psychosocial problems, because available treatments are increasingly effective.

Keywords

Psychoeducation Hepatitis C Psychiatric illness Antiviral therapy 

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Barry A. Hong
    • 1
  • Carol S. North
    • 2
  • David E. Pollio
    • 4
  • Anna Abbacchi
    • 1
  • Christine Debold
    • 5
  • Sunday A. Adewuyi
    • 3
  • Mauricio Lisker-Melman
    • 5
  1. 1.Department of PsychiatryWashington University, School of MedicineSt. LouisUSA
  2. 2.VA North Texas Health Care System, Departments of Psychiatry and Surgery/Division of Emergency MedicineUniversity of Texas Southwestern Medical CenterDallasUSA
  3. 3.Department of PsychiatryUniversity of Texas Southwestern Medical CenterDallasUSA
  4. 4.School of Social WorkUniversity of AlabamaTuscaloosaUSA
  5. 5.Department of MedicineWashington University School of MedicineSt. LouisUSA

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