Advertisement

Acceptability of Psychotherapy, Pharmacotherapy, and Self-Directed Therapies in Australians Living with Chronic Hepatitis C

  • Benjamin J. R. StewartEmail author
  • Deborah Turnbull
  • Antonina A. Mikocka-Walus
  • Hugh A. J. Harley
  • Jane M. Andrews
Article

Abstract

Despite the prevalence of psychiatric co-morbidity in chronic hepatitis C (CHC), treatment is under-researched. Patient preferences are likely to affect treatment uptake, adherence, and success. Thus, the acceptability of psychological supports was explored. A postal survey of Australian CHC outpatients of the Royal Adelaide Hospital and online survey of Australians living with CHC was conducted, assessing demographic and disease-related variables, psychosocial characteristics, past experience with psychological support, and psychological support acceptability. The final sample of 156 patients (58 % male) had significantly worse depression, anxiety, stress, and social support than norms. The most acceptable support type was individual psychotherapy (83 %), followed by bibliotherapy (61 %), pharmacotherapy (56 %), online therapy (45 %), and group psychotherapy (37 %). The most prominent predictor of support acceptability was satisfaction with past use. While individual psychotherapy acceptability was encouragingly high, potentially less costly modalities including group psychotherapy or online therapy may be hampered by low acceptability, the reasons for which need to be further explored.

Keywords

Hepatitis C Acceptability Mental health Psychotherapy Pharmacotherapy 

Notes

Acknowledgments

We would like to thank Nancy Briggs for providing statistical advice, in addition to Megan Phelps, Anton Colman, and Joanne Morgan for their assistance in data collection. The authors alone are responsible for the content and writing of the paper. This research received no specific funding from the public, commercial, or not-for-profit sectors.

Conflict of interest

The authors report no conflicts of interest.

References

  1. Australian Bureau of Statistics. (2008). Information paper: An introduction to Socio-Economic Indexes for Areas (SEIFA) 2006. Google Scholar
  2. Bandelow, B., Seidler-Brandler, U., Becker, A., Wedekind, D., & Rüther, E. (2007). Meta-analysis of randomized controlled comparisons of psychopharmacological and psychological treatments for anxiety disorders. World Journal of Biological Psychiatry, 8(3), 175–187.CrossRefPubMedGoogle Scholar
  3. Bedossa, P., Bioulac-Sage, P., Callard, P., Chevallier, M., Degott, C., Deugniar, Y., et al. (1994). Intraobserver and interobserver variations in liver biopsy interpretation in patients with chronic hepatitis C. Hepatology, 20, 15–20.Google Scholar
  4. Beltman, M. W., Oude Voshaar, R. C., & Speckens, A. E. (2010). Cognitive-behavioural therapy for depression in people with a somatic disease: Meta-analysis of randomised controlled trials. British Journal of Psychiatry, 197, 11–19.CrossRefPubMedGoogle Scholar
  5. Castera, L., Constant, A., Henry, C., Champbenoit, P., Bernard, P. H., De Ledinghen, V., et al. (2006). Impact on adherence and sustained virological response of psychiatric side effects during peginterferon and ribavirin therapy for chronic hepatitis C. Alimentary Pharmacology and Therapeutics, 24, 1223–1230.CrossRefPubMedGoogle Scholar
  6. Chainuvati, S., Khalid, S. K., Kancir, S., Shea, M., Edwards, J., Sernyak, M., et al. (2006). Comparison of hepatitis C treatment patterns in patients with and without psychiatric and/or substance use disorders. Journal of Viral Hepatitis, 13, 235–241.CrossRefPubMedGoogle Scholar
  7. Crepaz, N., Passin, W. F., Herbst, J. H., Rama, S. M., Malow, R. M., Purcell, D. W., et al. (2008). Meta-analysis of cognitive-behavioral interventions on HIV-positive persons’ mental health and immune functioning. Health Psychology, 27, 4–14.CrossRefPubMedGoogle Scholar
  8. Cuijpers, P., Donker, T., Johansson, R., Mohr, D. C., van Straten, A., & Andersson, G. (2011). Self-guided psychological treatment for depressive symptoms: A meta-analysis. PLoS ONE, 6(6), e21274.Google Scholar
  9. den Boer, P. C. A. M., Wiersma, D., & Van den Bosch, R. J. (2004). Why is self-help neglected in the treatment of emotional disorders? A meta analysis. Psychological Medicine, 34(6), 959–971.CrossRefPubMedGoogle Scholar
  10. Dillman, D. A. (1991). The design and administration of mail surveys. Annual Review of Sociology, 17, 225–249.CrossRefGoogle Scholar
  11. Dwight, M. M., Kowdley, K. V., Russo, J. E., Ciechanowski, P. S., Larson, A. M., & Katon, W. J. (2000). Depression, fatigue, and functional disability in patients with chronic hepatitis C. Journal of Psychosomatic Research, 49, 311–317.CrossRefPubMedGoogle Scholar
  12. Dwight-Johnson, M., Unutzer, J., Sherbourne, C., Tang, L., & Wells, K. B. (2001). Can quality improvement programs for depression in primary care address patient preferences for treatment? Medical Care, 39(9), 934–944.CrossRefPubMedGoogle Scholar
  13. El-Serag, H. B., Kunik, M., Richardson, P., & Rabeneck, L. (2002). Psychiatric disorders among veterans with hepatitis C infection. Gastroenterology, 123, 476–482.CrossRefPubMedGoogle Scholar
  14. Evon, D. M., Simpson, K. M., Esserman, D., Verma, A., Smith, S., & Fried, M. W. (2010). Barriers to accessing care in patients with chronic hepatitis C: The impact of depression. Alimentary Pharmacology and Therapeutics, 32, 1163–1173.CrossRefPubMedGoogle Scholar
  15. Evon, D. M., Simpson, K., Kixmiller, S., Galanko, J., Dougherty, K., Golin, C., et al. (2011). A randomized controlled trial of an integrated care intervention to increase eligibility for chronic hepatitis C treatment. American Journal of Gastroenterology, 106(10), 1777–1786.CrossRefPubMedGoogle Scholar
  16. Evon, D. M., Verma, A., Dougherty, K. A., Batey, B., Russo, M., Zacks, S., et al. (2007). High deferral rates and poorer treatment outcomes for HCV patients with psychiatric and substance use comorbidities. Digestive Diseases and Sciences, 52, 3251–3258.CrossRefPubMedGoogle Scholar
  17. Ghany, M. G., Nelson, D. R., Strader, D. B., Thomas, D. L., & Seeff, L. B. (2011). An update on treatment of genotype 1 chronic hepatitis C virus infection: 2011 Practice guideline by the American Association for the Study of Liver Diseases. Hepatology, 54, 1433–1444.CrossRefPubMedGoogle Scholar
  18. Gidding, H. F., Topp, L., Middleton, M., Robinson, K., Hellard, M., McCaughan, G., et al. (2009). The epidemiology of hepatitis C in Australia: Notifications, treatment uptake and liver transplantations, 1997–2006. Journal of Gastroenterology and Hepatology, 24, 1648–1654.CrossRefPubMedGoogle Scholar
  19. Gun, S. Y., Titov, N., & Andrews, G. (2011). Acceptability of internet treatment of anxiety and depression. Australasian Psychiatry, 19, 259–264.CrossRefPubMedGoogle Scholar
  20. Gutteling, J. J., Duivenvoorden, H. J., Busschbach, J. J. V., De Man, R. A., & Darlington, A. S. E. (2010). Psychological determinants of health-related quality of life in patients with chronic liver disease. Psychosomatics, 51, 157–165.PubMedGoogle Scholar
  21. Hauser, P., Khosla, J., Aurora, H., Laurin, J., Kling, M. A., Hill, J., et al. (2002). A prospective study of the incidence and open-label treatment of interferon-induced major depressive disorder in patients with hepatitis C. Molecular Psychiatry, 7, 942–947.CrossRefPubMedGoogle Scholar
  22. Holm, S. (1979). A simple sequentially rejective multiple test procedure. Scandinavian Journal of Statistics, 6(2), 65–70.Google Scholar
  23. Jorm, A. F., Christensen, H., Medway, J., Korten, A. E., Jacomb, P. A., & Rodgers, B. (2000). Public belief systems about the helpfulness of interventions for depression: Associations with history of depression and professional help-seeking. Social Psychiatry and Psychiatric Epidemiology, 35, 211–219.CrossRefPubMedGoogle Scholar
  24. Jorm, A. F., Korten, A. E., Jacomb, P. A., Rodgers, B., Pollitt, P., Christensen, H., et al. (1997). Helpfulness of interventions for mental disorders: Beliefs of health professionals compared with the general public. British Journal of Psychiatry, 171, 233–237.CrossRefPubMedGoogle Scholar
  25. Kraus, M. R., Schäfer, A., Al-Taie, O., & Scheurlen, M. (2005). Prophylactic SSRI during interferon alpha re-therapy in patients with chronic hepatitis C and a history of interferon-induced depression. Journal of Viral Hepatitis, 12, 96–100.CrossRefPubMedGoogle Scholar
  26. Kraus, M. R., Schäfer, A., Faller, H., Csef, H., & Scheurlen, M. (2002). Paroxetine for the treatment of interferon-α-induced depression in chronic hepatitis C. Alimentary Pharmacology and Therapeutics, 16, 1091–1099.CrossRefPubMedGoogle Scholar
  27. Lavanchy, D. (2011). Evolving epidemiology of hepatitis C virus. Clinical Microbiology and Infection, 17, 107–115.CrossRefPubMedGoogle Scholar
  28. Leutscher, P. D. C., Lagging, M., Buhl, M. R., Pedersen, C., Norkrans, G., Langeland, N., et al. (2010). Evaluation of depression as a risk factor for treatment failure in chronic hepatitis C. Hepatology, 52, 430–435.CrossRefPubMedGoogle Scholar
  29. Lewis, C., Pearce, J., & Bisson, J. I. (2012). Efficacy, cost-effectiveness and acceptability of self-help interventions for anxiety disorders: Systematic review. British Journal of Psychiatry, 200(1), 15–21.CrossRefPubMedGoogle Scholar
  30. Liang, T. J., Rehermann, B., Seeff, L. B., & Hoofnagle, J. H. (2000). Pathogenesis, natural history, treatment, and prevention of hepatitis C. Annals of Internal Medicine, 132, 296–305.CrossRefPubMedGoogle Scholar
  31. Loftis, J. M., Matthews, A. M., & Hauser, P. (2006). Psychiatric and substance use disorders in individuals with hepatitis C: Epidemiology and management. Drugs, 66, 155–174.CrossRefPubMedGoogle Scholar
  32. Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the Depression Anxiety Stress Scales (2nd ed.). Sydney, NSW: Psychology Foundation.Google Scholar
  33. Magill, M., & Ray, L. A. (2009). Cognitive-behavioral treatment with adult alcohol and illicit drug users: A meta-analysis of randomized controlled trials. Journal of Studies on Alcohol and Drugs, 70, 516–527.PubMedGoogle Scholar
  34. Martín-Santos, R., Díez-Quevedo, C., Castellví, P., Navinés, R., Miquel, M., Masnou, H., et al. (2008). De novo depression and anxiety disorders and influence on adherence during peginterferon-alpha-2a and ribavirin treatment in patients with hepatitis C. Alimentary Pharmacology and Therapeutics, 27, 257–265.CrossRefPubMedGoogle Scholar
  35. McDermut, W., Miller, I. W., & Brown, R. A. (2001). The efficacy of group psychotherapy for depression: A meta-analysis and review of the empirical research. Clinical Psychology: Science and Practice, 8, 98–116.CrossRefGoogle Scholar
  36. McDonald, J., Jayasuriya, R., Bindley, P., Gonsalvez, C., & Gluseska, S. (2002). Fatigue and psychological disorders in chronic hepatitis C. Journal of Gastroenterology and Hepatology, 17, 171–176.CrossRefPubMedGoogle Scholar
  37. Morasco, B. J., Huckans, M., Loftis, J. M., Woodhouse, J., Seelye, A., Turk, D. C., et al. (2010). Predictors of pain intensity and pain functioning in patients with the hepatitis C virus. General Hospital Psychiatry, 32, 413–418.CrossRefPubMedGoogle Scholar
  38. Nelligan, J. A., Loftis, J. M., Matthews, A. M., Zucker, B. L., Linke, A. M., & Hauser, P. (2008). Depression comorbidity and antidepressant use in veterans with chronic hepatitis C: Results from a retrospective chart review. Journal of Clinical Psychiatry, 69, 810–816.CrossRefPubMedGoogle Scholar
  39. Neri, S., Bertino, G., Petralia, A., Giancarlo, C., Rizzotto, A., Calvagno, G. S., et al. (2010). A multidisciplinary therapeutic approach for reducing the risk of psychiatric side effects in patients with chronic hepatitis C treated with pegylated interferon α and ribavirin. Journal of Clinical Gastroenterology, 44, e210–e217.CrossRefPubMedGoogle Scholar
  40. Perz, J. F., Armstrong, G. L., Farrington, L. A., Hutin, Y. J. F., & Bell, B. P. (2006). The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. Journal of Hepatology, 45, 529–538.CrossRefPubMedGoogle Scholar
  41. Raison, C. L., Broadwell, S. D., Borisov, A. S., Manatunga, A. K., Capuron, L., Woolwine, B. J., et al. (2005). Depressive symptoms and viral clearance in patients receiving interferon-α and ribavirin for hepatitis C. Brain, Behavior, and Immunity, 19, 23–27.CrossRefPubMedGoogle Scholar
  42. Raison, C. L., Woolwine, B. J., Demetrashvili, M. F., Borisov, A. S., Weinreib, R., Staab, J. P., et al. (2007). Paroxetine for prevention of depressive symptoms induced by interferon-alpha and ribavirin for hepatitis C. Alimentary Pharmacology and Therapeutics, 25, 1163–1174.CrossRefPubMedGoogle Scholar
  43. Reavley, N. J., & Jorm, A. F. (2011). Recognition of mental disorders and beliefs about treatment and outcome: Findings from an Australian National Survey of Mental Health Literacy and Stigma. Australian and New Zealand Journal of Psychiatry, 45, 947–956.CrossRefPubMedGoogle Scholar
  44. Reavley, N. J., & Jorm, A. F. (2012). Public recognition of mental disorders and beliefs about treatment: Changes in Australia over 16 years. British Journal of Psychiatry, 200, 419–425.CrossRefPubMedGoogle Scholar
  45. Rizzo, M., Creed, F., Goldberg, D., Meader, N., & Pilling, S. (2011). A systematic review of non-pharmacological treatments for depression in people with chronic physical health problems. Journal of Psychosomatic Research, 71, 18–27.CrossRefPubMedGoogle Scholar
  46. Schaefer, M., Schwaiger, M., Garkisch, A. S., Pich, M., Hinzpeter, A., Uebelhack, R., et al. (2005). Prevention of interferon-alpha associated depression in psychiatric risk patients with chronic hepatitis C. Journal of Hepatology, 42, 793–798.CrossRefPubMedGoogle Scholar
  47. Sharp, D. M., Power, K. G., & Swanson, V. (2004). A comparison of the efficacy and acceptability of group versus individual cognitive behaviour therapy in the treatment of panic disorder and agoraphobia in primary care. Clinical Psychology and Psychotherapy, 11, 73–82.CrossRefGoogle Scholar
  48. Sherbourne, C. D., & Stewart, A. L. (1991). The MOS social support survey. Social Science and Medicine, 32, 705–714.CrossRefPubMedGoogle Scholar
  49. Stewart, B. J., Mikocka-Walus, A. A., Harley, H., & Andrews, J. M. (2012). Help-seeking and coping with the psychosocial burden of chronic hepatitis C: A qualitative study of patient, hepatologist, and counsellor perspectives. International Journal of Nursing Studies, 49(5), 560–569.CrossRefPubMedGoogle Scholar
  50. Swift, J. K., & Callahan, J. L. (2009). The impact of client treatment preferences on outcome: A meta-analysis. Journal of Clinical Psychology, 65(4), 368–381.Google Scholar
  51. Swift, J. K., Callahan, J. L., & Vollmer, B. M. (2011). Preferences. Journal of Clinical Psychology, 67(2), 155–165.Google Scholar
  52. The Kirby Institute. (2011). HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2011. Sydney, NSW: The Kirby Institute, The University of New South Wales.Google Scholar
  53. Thomas, D. L., & Seeff, L. B. (2005). Natural history of hepatitis C. Clinics in Liver Disease, 9, 383–398.CrossRefPubMedGoogle Scholar
  54. Van Schaik, D. J. F., Klijn, A. F. J., Van Hout, H. P. J., Van Marwijk, H. W. J., Beekman, A. T. F., De Haan, M., et al. (2004). Patients’ preferences in the treatment of depressive disorder in primary care. General Hospital Psychiatry, 26, 184–189.CrossRefPubMedGoogle Scholar
  55. Vos, T., Corry, J., Haby, M. M., Carter, R., & Andrews, G. (2005). Cost-effectiveness of cognitive-behavioural therapy and drug interventions for major depression. Australian and New Zealand Journal of Psychiatry, 39, 683–692.PubMedGoogle Scholar
  56. Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361–370.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Benjamin J. R. Stewart
    • 1
    Email author
  • Deborah Turnbull
    • 1
  • Antonina A. Mikocka-Walus
    • 1
    • 2
  • Hugh A. J. Harley
    • 3
    • 4
  • Jane M. Andrews
    • 3
    • 4
  1. 1.School of PsychologyUniversity of AdelaideAdelaideAustralia
  2. 2.School of Nursing and MidwiferyUniversity of South AustraliaAdelaideAustralia
  3. 3.Department of Gastroenterology and HepatologyRoyal Adelaide HospitalAdelaideAustralia
  4. 4.Discipline of MedicineUniversity of AdelaideAdelaideAustralia

Personalised recommendations