Objective: The aim of this study is to document the relationship between anger dimensions (state, trait, expression, and control) and quality of life (QoL) in patients co-infected with HIV and hepatitis C virus (HCV).
Patients and methods: This is a cross-sectional study nested in the ANRS CO13-HEPAVIH French national cohort. Anger and QoL were assessed using self-administered questionnaires in 536 HIV–HCV-co-infected patients. Correlations between anger scores (STAXI-2 scale) and QoL scores (WHOQOL-HIV BREF scale) were assessed using Spearman’s coefficients. Multiple linear regression models were then used to test the relationship between the different dimensions of anger and QoL after adjustment for statistically significant psychosocial, sociobehavioral, and clinical characteristics.
Results: Patients with excessive alcohol use or history of injecting drug use had higher levels of anger. All dimensions of anger were significantly correlated with impaired QoL for all six dimensions of the WHOQOL-HIV BREF scale. Greater internal experience of anger and impaired anger control were confirmed as independent correlates of impaired QoL related to psychological health, social relationships, and patients’ beliefs after adjustment for depressive symptoms, functional impact of fatigue, socioeconomic status, and HIV-related characteristics.
Conclusion: Anger issues need close monitoring in HIV–HCV-co-infected patients, especially in patients with addictive behaviors. Screening for problems in anger management and implementing individualized psychotherapeutic strategies may help improve QoL in this population.
aAix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale
bORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d’Azur, Marseille
cUniversity of Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401
dCHU de Bordeaux, Pole de sante publique, Bordeaux
eDépartement d’Infectiologie, Centre Hospitalier Universitaire de Dijon Université de Bourgogne, Dijon
fService Maladies infectieuses et tropicales, Centre Hospitalier de Perpignan, Perpignan
gService Maladies infectieuses et tropicales, AP-HP, Hôpital Avicenne
hUniversité Paris 13 Nord, Bobigny
iService Médecine interne et Immunologie clinique, AP-HP, Hôpital Bicêtre, Hôpitaux universitaires Paris Sud
jUniversité Paris Sud
kService Maladies infectieuses et tropicales, AP-HP, Hôpital Bicêtre, Hôpitaux universitaires Paris Sud, Le Kremlin-Bicêtre
lUniversité Paris Descartes
mService Maladies infectieuses et tropicales, AP-HP, Hôpital Cochin, Paris, France
* Fabienne Marcellin and Camelia Protopopescu contributed equally to the writing of this article.
Correspondence to Fabienne Marcellin, PhD, INSERM UMR 912, SESSTIM, ORS PACA, 19-21 Boulevard Jean Moulin, Marseille 13005, France Tel: +33 413 732 299; fax: +33 484 256 172; e-mail: firstname.lastname@example.org
Received January 25, 2017
Accepted March 28, 2017