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The Use of Psychoeducation for a Patient with Hepatitis C and Psychiatric Illness in Preparation for Antiviral Therapy: A Case Report and Discussion

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Abstract

The standard of care treatment for chronic hepatitis C viral infection (HCV) is a combination of pegylated interferon alfa and ribavirin for 24–48 weeks according to the virus genotype. This therapy is known to have multiple neuropsychiatric side effects. A major concern when evaluating a patient for HCV treatment with a known history of a psychiatric disorder is the risk that the patient’s psychiatric disorder will flare or become unmanageable. The possibility of precipitating depression, confusion, mania, psychosis, hallucinations, or suicidal ideation or attempt is frequently an obstacle to treatment. We present the case of a 50 year-old man with HCV and an extensive psychiatric history involving alcoholism, depression, and suicidality who participated in a psychoeducation group to help prepare him for treatment with pegylated interferon alfa/ribavirin therapy. Though the patient derived much benefit from the psychoeducation group, by the time of evaluation for HCV treatment two months after the group ended he had relapsed back into a depressive episode with suicidal thoughts. His acute psychiatric status made him unacceptable for pegylated interferon alfa/ribavirin therapy. Psychoeducation groups show promise for helping patients with chronic medical illness to be ready for and endure intensive medical treatment that has substantial psychiatric side effects. The challenge is to help patients overcome barriers to treatment, particularly psychosocial problems, because available treatments are increasingly effective.

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Acknowledgments

This research was supported by the National Institute on Alcohol Abuse and Alcoholism, grant RO1-015201 to Dr. North. Points of view in this document are those of the authors and do not necessarily represent the official position of NIAAA, the Department of Veterans Affairs, or the U.S. Government.

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Authors and Affiliations

  1. Department of Psychiatry, Washington University, School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, St. Louis, MO, 63110, USA

    Barry A. Hong & Anna Abbacchi

  2. VA North Texas Health Care System, Departments of Psychiatry and Surgery/Division of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Carol S. North

  3. Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Sunday A. Adewuyi

  4. School of Social Work, University of Alabama, Tuscaloosa, AL, USA

    David E. Pollio

  5. Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA

    Christine Debold & Mauricio Lisker-Melman

Authors
  1. Barry A. Hong
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  2. Carol S. North
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  3. David E. Pollio
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  4. Anna Abbacchi
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  5. Christine Debold
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  6. Sunday A. Adewuyi
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  7. Mauricio Lisker-Melman
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Correspondence to Barry A. Hong.

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Hong, B.A., North, C.S., Pollio, D.E. et al. The Use of Psychoeducation for a Patient with Hepatitis C and Psychiatric Illness in Preparation for Antiviral Therapy: A Case Report and Discussion. J Clin Psychol Med Settings 18, 99–107 (2011). https://doi.org/10.1007/s10880-011-9227-6

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  • DOI: https://doi.org/10.1007/s10880-011-9227-6

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