Association Between Viral Hepatitis and Depressive Symptoms: National Health and Nutrition Examination Survey (NHANES) 2007-2018

Background: Viral hepatitis has been associated with mental health challenges; however, large-scale epidemiological evidence remains scarce. This cross-sectional study aimed to examine the association between viral hepatitis (hepatitis B or C) and depressive symptoms. Methods: We analyzed data from the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2018. Hepatitis B and C virus infections were identified through serological testing, and depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). Weighted multivariable logistic regression models were applied, along with subgroup and interaction analyses. Results: A total of 25,316 participants were included. After adjusting for potential confounders, viral hepatitis was a positive associated with depressive symptoms (OR = 1.72, 95% CI: 1.22–2.43). When depressive symptoms were categorized by severity, viral hepatitis was significantly associated with mild (OR = 1.85, 95% CI: 1.29–2.65), moderate (OR = 2.94, 95% CI: 1.95–4.43), and severe depression (OR = 1.74, 95% CI: 1.08–2.81). A positive association was also found between hepatitis infection and PHQ-9 total scores (β = 1.08, 95% CI: 0.38–1.77, P = 0.003). This association remained consistent across subgroups, with no significant interactions observed. Conclusions: Viral hepatitis is independently associated with a higher risk of depressive symptoms. These findings underscore the importance of routine mental health screening and integrated psychological support for individuals with hepatitis B or C. Longitudinal studies are warranted to establish causality.