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SUMMARYBackground: Psychiatric side-effects may require dose reduction or premature discontinuation of interferon therapy in chronic hepatitis C. New strategies are needed in order to prevent the premature termination of interferon therapy. Aim: To evaluate prospectively the efficacy and tolerability of antidepressant therapy (paroxetine, a selective serotonin reuptake inhibitor) in patients with chronic hepatitis C treated with interferon-a who have developed interferon-induced major depression. Methods: A sub-group of 14 individuals from 121 consecutively treated hepatitis C patients developed substance-induced major depression without suicidal ideation during interferon-a treatment. The individuals in this sub-group received paroxetine after the occur-

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Little is known about the psychological burden patients are left with after successful allogeneic hematopoietic SCT (HSCT). With the main focus on physical condition and common transplant complications, psychological symptoms often remain neglected in daily practice. To assess the prevalence of distress in patients who have undergone allogeneic HSCT, we conducted a cross-sectional pilot study in 50 consecutive patients from our outpatient transplant clinic using standardized questionnaires. Distress was categorized by symptoms of anxiety, fear of progression, depression and post-traumatic stress disorder (PTSD). Forty-one patients completed self-administered questionnaires. The median age was 53 years (21-74 years) and the mean time after transplantation was 614 days (25-2070 days). In total, 18 patients (44%) showed symptoms of distress. Among these 18 patients, 11 patients reported symptoms of anxiety, 12 patients suffered from fear of progression, 11 patients showed symptoms of depression and 6 patients of PTSD. Age below 55 years was significantly associated with fear of progression (P ¼ 0.004). This study demonstrates the high prevalence of distress in patients who have undergone allogeneic HSCT. Our results suggest an unmet need for professional support and intervention. These findings may be relevant as distress could have an influence on the outcome after HSCT.

Our findings suggest that the extent and frequency of depressive symptoms in total are not reduced by peginterferon. Monitoring and management of neuropsychiatric toxicity especially depression have to be considered as much as in antiviral therapy with unmodified interferon.