Study On The Relationship And Related Factors Between Chronic Hepatitis B And Mental Disorders

Objective To investigate the incidence of mental and psychological disorders(such as depression,anxiety,insomnia,etc.)and related influencing factors in patients with chronic hepatitis B(CHB).Methods A total of 130 patients with chronic hepatitis B who were admitted to the Department of Infectious Diseases of the Affiliated Hospital of Qingdao University from November 2017 to May 2018 were enrolled.The Hamilton Depression Scale(HAMD),the Hamilton Anxiety Scale(HAMA),and the Asens Insomnia Scale(AIS)were used to evaluate the psychosocial state of patients and to explore the incidence of mental and psychological disorders in patients with CHB.According to the HAMD,HAMA,and AIS scores,the patients were divided into depression group,anxiety group and insomnia group.CHB patients without mental disorder were used as the control group.The general situation of each group was gender,age,body mass index(BMI),Degree of education,smoking history,history of drinking,history of hypertension,history of diabetes,and whether or not to receive antiviral therapy,liver function: aspartate aminotransferase(AST),alanine aminotransferase(ALT),γ-glutamyl transferase(GGT),Alkaline phosphatase(ALP),total bilirubin(TBIL)and albumin(ALB),prothrombin time(PT),total cholesterol(TC),HBV DNA,glycocholic acid(CG),liver fibrosis Indicators:laminin(LN),type III procollagen N-terminal peptide(PIIIP NP),hyaluronic acid(HA),lipopolysaccharide(LPS),cirrhosis degree,comparative analysis of depression,anxiety and insomnia Influencing factors.Results(1)The prevalence of mental disorders in 130 patients with CHB in this study was 51.5%,that is,about half of CHB patients had mental disorders(depression,anxiety or insomnia),and the prevalence of depression in CHB patients was 32.3%,the prevalence of anxiety was 42.3%,the prevalence of insomnia was 45.4%,and the prevalence of depression,anxiety and insomnia were 27.7%.(2)The severity of depression was positively correlated with AST,TBIL,PT,CG levels(F values were 4.193,4.603,6.330,6.954,P <0.05).The higher the level,the more severe the depression.Age,glycocholic acid,and lipopolysaccharide were independent risk factors for depression(OR = 12.376,95% CI: 1.310-116.933,P = 0.028;OR = 1.073,95% CI: 1.008-1.142,P = 0.028;OR = 1.005)95% CI: 1.000-1.009,P =0.050),CHB patients aged 40-50 years were more susceptible to depression than patients older than 60 years.(3)The severity of anxiety was associated with the presence or absence of cirrhosis and cirrhosis(Fisher,P=0.032).Anxiety was positively correlated with TBIL,PT,CG,PIIIP N-P levels(F values were 5.115,5.499,3.602,7.662,P <0.05),and the higher the level,the more severe the anxiety.Anxiety was negatively correlated with TC levels(F=3.602,P=0.030).Age,lipopolysaccharide was an independent risk factor for anxiety(OR = 9.775,95% CI: 1.388-68.824,P = 0.022;OR = 1.005,95% CI: 1.000-1.010,P =0.049),CHB 40-50 years old Patients are more susceptible to anxiety than patients older than 60 years of age.(4)There was no correlation between the severity of insomnia and the general condition,liver function,liver fibrosis and cirrhosis of the patients.Lipopolysaccharide was an independent risk factor for insomnia(OR = 1.007,95% CI: 1.001-1.013,P =0.014).Conclusion Chronic hepatitis B patients often have mental disorders,such as depression,anxiety,and insomnia.Patients with chronic hepatitis B complicated with mental and psychological disorders are related to various factors such as age,liver function,liver fibrosis,cirrhosis and lipopolysaccharide.Different types of mental and psychological disorders have different influencing factors.Lipopolysaccharide is an independent risk factor for depression,anxiety and insomnia,and its mechanism needs further study.