Amin A Muhammad Gadit.
Mood disorder associated with gastrointestinal and liver diseases: are there many challenges?.
J Pak Med Assoc Jan ;71(12):1064-5.

With the high prevalence of hepatitis and other gastrointestinal illness in the country, we come across the mental health consequences of such medical problems. The major issues are with depression and anxiety. It is quite understandable that physical illnesses bring in with them stress that is intrinsic by virtue of the serious nature of medical illness, the socio-economical repercussions and the uncertain prognosis in terms of the nature of illness. The major mental health problem that these patients are referred with is depression that can be of moderate to severe intensity. Depression in itself is a separate clinical entity that calls for treatment. This becomes challenging for mental health professional in a number of ways, first to educate the patient that there is another illness to be dealt with, the type of tailored psychotherapy that the individual person would need and above all, the biological treatment in terms of its suitability, side effects and interaction with the medications already been prescribed for the medical condition in question. One particular drug is notoriously known for inducing depression is Interferon. Here the challenge for management of depression becomes more acute. However, there are a number of success stories that are quite encouraging. Though several experts claim that antiviral therapy should not be given to HCV patients having psychiatric problems, this has proven wrong in clinical trials as SSRI (selective serotonin uptake inhibitors) have proven effective. (Opinioi).

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