Hepatitis C in patients with psychiatric disease and substance abuse: Screening strategies and comanagement models of care
Tóm tắt
Increasingly, hepatologists and other health care providers have recognized the need for a systematic approach to hepatitis C that addresses the common comorbidities of psychiatric and substance use disorders, and one that demands active participation from mental health care providers. The majority of new and existing cases of hepatitis C are related to injection drug use, and in this population the prevalence of psychiatric comorbidity is high. Optimally, all hepatitis C-positive patients should be screened for psychiatric and substance use disorders prior to antiviral therapy. If a patient screens positive, he or she should be referred to a mental health care provider or addiction specialist, assessed for the presence of a psychiatric or substance use disorder, and appropriately treated prior to initiation of antiviral therapy. Although interferon therapy can lead to severe neuropsychiatric side effects, including suicidality, evidence suggests that many patients with comorbid psychiatric and substance use diagnoses can be treated safely and effectively using comanagement strategies.
Tài liệu tham khảo
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