Keywords: hepatitis C, Depression, beck depression inventory


 Introduction: Pre-existing psychiatric illnesses, such as mood and psychotic disorders, are 3–4 times more common and frequently undetected in HCV patients. This could be brought on by a diminished desire to use or access mental and primary health care services, actual or imagined stigma against HCV patients, or denial of their psychiatric symptoms. Comorbid depression can impact the outcome because it is linked to decreased HCV therapy adherence.

Objectives: To quantify the prevalence of depression among Hepatitis C patients not receiving treatment.

Study Design: This was a cross-sectional study.

Setting: Medical Department, Faisalabad Medical University and affiliated Allied Hospital, Faisalabad.

Study duration: 30th December 2021 to 29th June 2022.

Materials & Methods: A total of 310 patients having  Hepatitis C infection, with an age range of 20 years to 60 years, were included, while the patients suffering from an additional underlying chronic medical disease like CKD, COPD and diabetes, which can cause depression, were excluded. Demographic data, including age, gender, residence (rural or urban), education of patient (Primary,   middle or higher education), marital status (single, married or separated), income of patient and duration of Hepatitis C infection were recorded. The researcher interviewed the selected patients by using Beck Depression Inventory. 

Results: The study's age ranged from 20 to 60 years, with a mean age of 41.75 + 8.62. Most 163 patients (52.58%) were in the 20–40 age range. 166 (53.55%) of the 310 patients were men, and 144 (46.45%) were women, for a male-to-female ratio of 1.2:1. In our study, the frequency of depression in patients with Hepatitis C infection not receiving any treatment was found in 187 (60.32%) patients.

Conclusion: The conclusion of the study is that the frequency of depression in patients suffering from Hepatitis C infection not receiving any treatment is very high.


Download data is not yet available.

Author Biographies

Muhammad Owais Fazal, Faisalabad Medical University, Punjab, Pakistan

Associate Professor, Department of Medicine.

Ghulam Abbas Tahir, Faisalabad Medical University. Punjab, Pakistan

Assistant Professor, Department of Medicine.

Yasir Yaqoob, Faisalabad Medical University, Punjab, Pakistan

Assistant Professor, Department of Medicine.


Waheed Y, Shafi T, Safi SZ, Qadri I. Hepatitis C virus in Pakistan: a systematic review of prevalence, genotypes and risk factors. World J Gastroenterol. 2009;15(45):5647-5653. doi:10.3748/wjg.15.5647

Umer M, Iqbal M. Hepatitis C virus prevalence and genotype distribution in Pakistan: Comprehensive review of recent data. World J Gastroenterol. 2016;22(4):1684-1700. doi:10.3748/wjg.v22.i4.1684

Bhutto AR, Jatt MI, Rafi S, Washdev W, Arsalan M, Ullah A. Frequency of anxiety and depression in chronic hepatitis c patients visiting a tertiary care hospital at gadap town, karachi. J Postgrad Med Inst [I. 2019 ;33(2). Available from:

Carepatron [Internet]. [cited 2023 Sep 3]. Available from:

WHO. Epidemiological update: increasing mortality calls for action 03. Glob Hepat report, 2017. 2017;7–20. Available from:

Oriolo G, Egmond E, Mariño Z, et al. Systematic review with meta-analysis: neuroimaging in hepatitis C chronic infection. Aliment Pharmacol Ther. 2018;47(9):1238-1252. doi:10.1111/apt.14594

Yarlott L, Heald E, Forton D. Hepatitis C virus infection, and neurological and psychiatric disorders - A review. J Adv Res. 2017;8(2):139-148. doi:10.1016/j.jare.2016.09.005

Ashraf S, Ahmad A. Viral hepatitis in Pakistan: challenges and priorities. Asian Pac J Trop Biomed. 2015;5(3):190–1. doi:

Lee K, Otgonsuren M, Younoszai Z, Mir HM, Younossi ZM. Association of chronic liver disease with depression: a population-based study. Psychosomatics. 2013;54(1):52-59. doi:10.1016/j.psym.2012.09.005

el-Serag HB, Kunik M, Richardson P, Rabeneck L. Psychiatric disorders among veterans with hepatitis C infection. Gastroenterology. 2002;123(2):476-482. doi:10.1053/gast.2002.34750

Fireman M, Indest DW, Blackwell A, Whitehead AJ, Hauser P. Addressing tri-morbidity (hepatitis C, psychiatric disorders, and substance use): the importance of routine mental health screening as a component of a comanagement model of care. Clin Infect Dis. 2005;40 Suppl 5:S286-S291. doi:10.1086/427442

Evon DM, Ramcharran D, Belle SH, et al. Prospective analysis of depression during peginterferon and ribavirin therapy of chronic hepatitis C: results of the Virahep-C study. Am J Gastroenterol. 2009;104(12):2949-2958. doi:10.1038/ajg.2009.528

Weinstein AA, Kallman Price J, Stepanova M, et al. Depression in patients with nonalcoholic fatty liver disease and chronic viral hepatitis B and C. Psychosomatics. 2011;52(2):127-132. doi:10.1016/j.psym.2010.12.019

Stewart B, Mikocka-Walus A, Morgan J, et al. Anxiety and depression in Australian chronic hepatitis C outpatients: prevalence and predictors. Australas Psychiatry. 2012;20(6):496-500. doi:10.1177/1039856212460597

Wang Z, Du J, Zhao M, Page K, Xiao Z, Mandel JS. Hepatitis C virus infection is independently associated with depression among methadone maintenance treatment heroin users in China. Asia Pac Psychiatry. 2013;5(3):191-196. doi:10.1111/j.1758-5872.2012.00209.x

Carta MG, Hardoy MC, Garofalo A, et al. Association of chronic hepatitis C with major depressive disorders: irrespective of interferon-alpha therapy. Clin Pract Epidemiol Ment Health. 2007;3:22. doi:10.1186/1745-0179-3-22

Kraus MR, Schäfer A, Csef H, Scheurlen M, Faller H. Emotional state, coping styles, and somatic variables in patients with chronic hepatitis C. Psychosomatics. 2000;41(5):377-384. doi:10.1176/appi.psy.41.5.377

Schäfer A, Wittchen HU, Seufert J, Kraus MR. Methodological approaches in the assessment of interferon-alfa-induced depression in patients with chronic hepatitis C - a critical review. Int J Methods Psychiatr Res. 2007;16(4):186-201. doi:10.1002/mpr.229

Kenny-Walsh E. Clinical outcomes after hepatitis C infection from contaminated anti-D immune globulin. Irish Hepatology Research Group. N Engl J Med. 1999;340(16):1228-1233. doi:10.1056/NEJM199904223401602

Lee DH, Jamal H, Regenstein FG, Perrillo RP. Morbidity of chronic hepatitis C as seen in a tertiary care medical center. Dig Dis Sci. 1997;42(1):186-191. doi:10.1023/a:1018818012378

Schäfer A, Scheurlen M, Seufert J, et al. Platelet serotonin (5-HT) levels in interferon-treated patients with hepatitis C and its possible association with interferon-induced depression. J Hepatol. 2010;52(1):10-15. doi:10.1016/j.jhep.2009.10.007

Husain N, Creed F, Tomenson B. Depression and social stress in Pakistan. Psychol Med. 2000;30(2):395-402. doi:10.1017/s0033291700001707

Quek TT, Tam WW, Tran BX, et al. The Global Prevalence of Anxiety Among Medical Students: A Meta-Analysis. Int J Environ Res Public Health. 2019;16(15):2735. Published 2019 Jul 31. doi:10.3390/ijerph16152735

Ahmed I, Banu H, Al-Fageer R, Al-Suwaidi R. Cognitive emotions: depression and anxiety in medical students and staff. J Crit Care. 2009;24(3):e1-e7. doi:10.1016/j.jcrc.2009.06.003

How to Cite
Fazal MO, Bilal A, Tahir GA, Yaqoob Y, Ahmed K, Izzat A. FREQUENCY OF DEPRESSION IN PATIENTS OF CHRONIC HEPATITIS C BEFORE STARTING TREATMENT. J Pak Psychiatr Soc [Internet]. 2023Dec.30 [cited 2024Jul.13];20(04):21-5. Available from: