Psychiatric comorbidity among hepatitis C-positive patients.

This study assessed the prevalence of psychiatric disorders among hepatitis C patients at a Veterans Affairs Medical Center. Medical records of 306 randomly selected hepatitis C-positive patients were reviewed for past and present DSM-IV-based psychiatric disorders. Each psychiatric diagnosis was independently confirmed with DSM-IV criteria using symptoms recorded in the chart. Only independently confirmed diagnoses were included for analysis. Mood disorders were present in 38% of patients; personality disorders in 30%; PTSD in 19%; other anxiety disorders in 9%; and psychotic disorders in 17%. Although alcohol use disorders were found in 86% of this patient population, intravenous drug use disorders were present in only 28%. Our data indicate that prevalence rates of a variety of psychiatric disorders are higher in veterans with hepatitis C than in the general population. Mood, anxiety, personality, and psychotic disorders were all relatively common in these patients. Psychiatric disorders may influence the course and treatment of hepatitis C infection, and psychiatrists as well as internists should be aware of the substantial psychiatric comorbidity in patients with this infection.

Reemergence of tardive dyskinesia after discontinuation of clozapine treatment.

Tardive dyskinesia (TD) continues to be a significant health problem and a serious limitation to neuroleptic medication treatment. Clozapine treatment may reduce the severity of TD but it is unclear wether the medication temporarily suppresses symptoms or leads to a sustain resolution of the disorder. Herein we describe two cases with severe TD which clozapine had to be discontinued. These cases suggest that clozapine provides a temporary suppression of TD rather than a permanent resolution of the disorder.