Psychosocial Adjustment

The neuropsychiatric effects of hepatitis—most notably symptoms of fatigue, depression, and cognitive dysfunction (Ozkan et al. 2006)—have long been recognized, although pediatric-specific research is limited. Fatigue is reported to occur in more than 50% of patients with hepatitis C (Saunders 2008). The presence of comorbid depression has a significant negative impact on health-related quality of life in those with hepatitis C (Ozkan et al. 2006), and rates of depression as high as 30% have been reported in untreated patients with hepatitis C (Die-perink et al. 2000; Saunders 2008). Patients infected with hepatitis C have also been reported to have subcortical frontal cerebral dysfunction that manifests as impaired concentration and slow processing prior to the development of cirrhosis and hepatic enceph-alopathy (Perry et al. 2008; Saunders 2008).

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