Academic journal article Journal of Psychological and Educational Research

A Short Psychotherapeutic Intervention on Depression Complicated by a Chronic B Virus Infection: A Case Study

Academic journal article Journal of Psychological and Educational Research

A Short Psychotherapeutic Intervention on Depression Complicated by a Chronic B Virus Infection: A Case Study

Article excerpt


The purpose of this case study is to describe the therapeutic interventions included in eleven therapy sessions that stimulated change in a young man who suffered from a depressive episode. The therapy took into account the HBS infection as a favoring factor for depressive symptoms. The separation from his girlfriend and perceived stress at work caused the difficulties brought up in therapy. The case was successfully solved due to patient's motivation and the investment in the therapeutic relationship.

Main complaints

The therapy began on June 9, 2012, after the client went through two weeks of illness characterized by extremely intense headaches, exhaustion, derealization and hypersomnia. Investigations revealed that Stefan was "brought down" by two main factors: the separation from his girlfriend, Larisa, the stress of a high workload in a managerial position and enrollment in a Master's program in economics. The conditions described in hindsight for the two weeks included: fatigue, severe headache, inability to cope with the entire work program, inconsistency, feelings of déjà vu, de-realization ("I remembered things that I thought I dreamed of"), signs of what would be suspected as a mild case of paranoid ideation ("suspicious of everybody"), anhedonia, aboulia.

Stefan is an intelligent man, courteous, thorough but somehow a hypochondriac, with emotional maturity in development. His appearance is always very stylish and clean. He is reserved regarding his personal life, but he has difficulties in saying "No" to other people's requests. The patient is very active, constantly on the go. He doesn't usually spend time alone: he has feelings of guilt when doing nothing (codependent of work). Stefan's resources include jogging, meeting with friends, reading, walking, the curiosity to learn new things, chilling out music and personal care.

Personal history of the patient

The relationship with Larisa, a twenty-year-old girl, seems to be central to the initial discussions. Stefan is a spontaneous, sexually active, athletic man and a former athlete. Larisa is for Stefan his first deep emotional experience. After repeated accusations of infidelity toward him, the two partners split up. The separation took place two weeks before the depressive episode previously described.

The family's genogram includes both parents aged 52, an older brother married and abroad (31) and an older sister (28) who still lives with their parents. Stefan is the youngest of the three brothers in the family. Early on, he practiced football, he had success locally but had to give up sports because of a foot injury and because of B Hepatitis detected at the age of 17 (infected, it seems, iatrogenic). The patient finished the Faculty of Physical Education and left three times through Work and Travel program in the United States, a place that Stefan is now very attached to (e.g.: his e-mail is signed both by the number of Romania, but also with a number in the USA). In the United States, Stefan had an extreme work program (with just three hours of sleep per night). On return, he obtained a managerial position in a distribution company. He is highly appreciated by his employer, and in the meantime, he finished the first year of Master's program. The HBS viraemia seems to be under control, in collaboration with an infectious disease doctor. Therapist took into account the probable involvement of this disease in his general state of depression.

Chronic B virus infection

A chronic infection of hepatitis B and hepatitis C are considered as the most important infectious diseases, which leads to drastic consequences, such as liver dysfunction. Depression is a psychiatric disorder, which is concomitantly present in these patients and decreases the patients' quality of life. There is a high prevalence of depression among patients with the hepatitis B and hepatitis C infection; hence, these patients should be repeatedly evaluated for depression (Aktug Demir et al. …

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