Incidence of depression in patients with chronic hepatitis C receiving combination therapy of pegylated interferon-alpha and ribavirin

A Reciprocal Link Between Gut Microbiota, Inflammation and Depression: A Place for Probiotics?

Depression is a severe mental disorder that places a significant economic burden on public health. The reciprocal link between the trillions of bacteria in the gut, the microbiota, and depression is a controversial topic in neuroscience research and has drawn the attention of public interest and press coverage in recent years. Mounting pieces of evidence shed light on the role of the gut microbiota in depression, which is suggested to involve immune, endocrine, and neural pathways that are the main components of the microbiota-gut-brain axis. The gut microbiota play major roles in brain development and physiology and ultimately behavior. The bidirectional communication between the gut microbiota and brain function has been extensively explored in animal models of depression and clinical research in humans. Certain gut microbiota strains have been associated with the pathophysiology of depression. Therefore, oral intake of probiotics, the beneficial living bacteria and yeast, may represent a therapeutic approach for depression treatment. In this review, we summarize the findings describing the possible links between the gut microbiota and depression, focusing mainly on the inflammatory markers and sex hormones. By discussing preclinical and clinical studies on probiotics as a supplementary therapy for depression, we suggest that probiotics may be beneficial in alleviating depressive symptoms, possibly through immune modulation. Still, further comprehensive studies are required to draw a more solid conclusion regarding the efficacy of probiotics and their mechanisms of action.

Psychiatric Morbidity, Fatigue, Stigma and Quality of Life of Patients With Hepatitis B Infection

AIMS

This study aimed to evaluate the prevalence of psychiatric morbidity, fatigue, stigma and quality of life (QOL) of patients with hepatitis B infection. Additional aim of the study was to evaluate the correlates of psychiatric morbidity and QOL in patients with hepatitis B infection.

METHODS

A total of 150 patients with hepatitis B virus (HBV) infection (75 inactive carriers and 75 patients with chronic hepatitis) were evaluated on Mini International Neuropsychiatric Interview-PLUS, World Health Organization-QOL-BREF scale, Chronic Liver Disease Questionnaire, Toronto Chinese HBV Stigma Scale, HBV knowledge scale and Fatigue Severity scale.

RESULTS

About half of the study participants (49.3%) had at least one lifetime psychiatric morbidity and of these more than one-third (37.3%) fulfilled at least one current psychiatric diagnosis. Generalized anxiety disorder was seen in 19.3% of the participants. Major depressive disorder was the second most common psychiatric diagnosis fulfilled at the time of assessment, with nearly equal prevalence of first episode of depression (8%) and recurrent depressive disorder (7.3%). Compared to those with inactive hepatitis, patients in the chronic hepatitis group had poorer QOL and experienced more fatigue. However, both the groups did not differ in terms of knowledge and stigma. Compared to those without current or lifetime psychiatric diagnosis, those with current or lifetime psychiatric diagnosis had poorer QOL, higher level of stigma and higher fatigue scale.

CONCLUSION

About half of the patients with HBV infection have psychiatric morbidity, which has negative impact on QOL of patients. Hence, it is important to recognize psychiatric morbidity among patients with HBV.