An Aggravated Trajectory of Depression and Anxiety Co-morbid with Hepatitis C: A Within-groups Study of 61 Australian Outpatients

Benjamin J.R. Stewart1, *, Deborah Turnbull1, Antonina A. Mikocka-Walus2, Hugh Harley4, Jane M. Andrews3, 4
1 School of Psychology, University of Adelaide, Australia;
2 Department of Health Sciences, University of York, United Kingdom;
3 Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Australia;
4 Discipline of Medicine, University of Adelaide, Australia

Article Metrics

CrossRef Citations:
Total Statistics:

Full-Text HTML Views: 805
Abstract HTML Views: 459
PDF Downloads: 188
Total Views/Downloads: 1452
Unique Statistics:

Full-Text HTML Views: 493
Abstract HTML Views: 311
PDF Downloads: 149
Total Views/Downloads: 953

Creative Commons License
© Stewart et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the (, which permits unrestricted, noncommercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the School of Psychology, University of Adelaide, North Terrace, Adelaide, South Australia 5005, Australia; Tel: +61 8 8303 3136; E-mail:


Background: This study aimed to explore the course of depression and anxiety in chronic hepatitis C patients. Methods:  Data were combined from two studies: (1) Hospital Anxiety and Depression Scale (HADS) scores in 395 consecutive Australian outpatients from 2006 to 2010 formed the baseline measurement; and (2) Depression Anxiety Stress Scales (DASS) scores in a survey of a sub-sample of these patients in 2011 formed the follow-up measurement. After converting DASS to HADS scores, changes in symptom scores and rates of case-ness (≥8), and predictors of follow-up symptoms were assessed. Results:  Follow-up data were available for 61 patients (70.5% male) whose age ranged from 24.5 to 74.6 years (M=45.6). The time to follow-up ranged from 20.7 to 61.9 months (M=43.8). Baseline rates of depression (32.8%) and anxiety (44.3%) increased to 62.3% and 67.2%, respectively. These findings were confirmed, independent of the conversion, by comparing baseline HADS and follow-up DASS scores with British community norms. Baseline anxiety and younger age predicted depression, while baseline anxiety, high school non-completion, and single relationship status predicted anxiety. Conclusion:  This study demonstrated a worsening trajectory of depression and anxiety. Further controlled and prospective research in a larger sample is required to confirm these findings.

Keywords: Anxiety, depression, hepatitis C, prognosis, trajectory.