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The Role of Attachment Style and Depression in Patients with Hepatitis C

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Abstract

Patients infected with chronic hepatitis C virus (HCV) commonly suffer from the triad of depression, pain and fatigue. This symptom triad in HCV is likely influenced by additional psychological and interpersonal factors, although the relationship is not clearly understood. This retrospective study aimed to characterize the relationship between attachment style and depressive and physical symptoms in the HCV-infected population. Over 18 months, 99 consecutively referred HCV infected patients were assessed with the Hamilton Depression Rating Scale (HDRS), Fatigue Severity Scale, Patient Health Questionnaire-15 for physical symptoms and the Relationship Questionnaire for attachment style. An ANOVA was used to identify differences between attachment styles and Pearson correlations were used to evaluate the association between depression, fatigue and physical symptoms. Approximately 15 % of patients in the sample had a fearful attachment style. Patients with fearful attachment style had significantly higher depressive symptoms compared to a secure attachment style (p = .025). No differences in physical and fatigue symptoms were observed between attachment styles. Further, HDRS scores were significantly associated with fatigue scores (p < .001) and physical symptoms (p < .001), reinforcing the relationship between these symptom domains in HCV-infected patients. Although depressive, physical and fatigue symptoms are inter-related in HCV-infected patients, our study results suggest that only depressive symptoms were influenced by the extremes of attachment style. Screening of relationship styles may identify at-risk HCV-infected individuals for depression who may have difficulty engaging in care and managing physical symptoms.

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Authors and Affiliations

  1. Department of Psychiatry, Program in Medical Psychiatry, University Health Network, University of Toronto, Toronto, ON, Canada

    Sanjeev Sockalingam, Diana Blank & Susan E. Abbey

  2. Hepatology and Mental Health Service, University Health Network, Toronto, ON, Canada

    Sanjeev Sockalingam & Diana Blank

  3. Department of Psychiatry, University of Toronto, Toronto, ON, Canada

    Sanjeev Sockalingam, Diana Blank & Susan E. Abbey

  4. Consultation Liaison Psychiatrist, King Saud University, Riyadh, Saudi Arabia

    Abdulqader Al Jarad & Fahad Alosaimi

  5. Toronto Western Hospital, Toronto, ON, Canada

    Gideon Hirschfield

  6. University Health Network, Toronto General Hospital, 200 Elizabeth Street-8EN-228, Toronto, ON, M5G 2C4, Canada

    Sanjeev Sockalingam

  7. Centre for Liver Research, NIHR Biomedical Research Unit, University of Birmingham, Birmingham, UK

    Gideon Hirschfield

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  1. Sanjeev Sockalingam
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  2. Diana Blank
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  3. Abdulqader Al Jarad
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  4. Fahad Alosaimi
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  5. Gideon Hirschfield
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  6. Susan E. Abbey
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Correspondence to Sanjeev Sockalingam.

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Sockalingam, S., Blank, D., Jarad, A.A. et al. The Role of Attachment Style and Depression in Patients with Hepatitis C. J Clin Psychol Med Settings 20, 227–233 (2013). https://doi.org/10.1007/s10880-012-9335-y

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