Association of Changes in Mood Status and Psychosocial Well-Being with Depression During Interferon-Based Treatment for Hepatitis C

Abstract

ObjectiveThe aims of this prospective study were to investigate temporal changes in mood status and distress level, as well as the development of depression, during pegylated interferon (PEG-IFN)-based treatment of patients with chronic hepatitis C (CHC). We also explored whether baseline demographic, psychiatric, and personality traits predicted the evolution of depression.MethodsCHC patients without depression were screened with laboratory tests; psychiatric interviews; and evaluations of mood symptoms, level of distress, and personality traits. A total of 67 treatment-naïve patients with CHC were consecutively treated with PEG-IFN-α-2a plus ribavirin for 48 (genotype 1, n=29) or 24 (genotype 2, n=38) weeks. Patients were followed prospectively every 4 weeks during the treatment period.ResultsSeven patients (10.4%) were diagnosed with major depressive disorder (MDD), and eight (11.9%) developed subsyndromal depression. Times to onset of MDD and subsyndromal depression were 6.67±5.01 and 11.11±5.58 weeks, respectively, after initiation of treatment. Patients who developed MDD had significantly increased fatigue and anxiety and poor psychological well-being during the course of treatment. Pretreatment subthreshold mood symptoms were a significant predictor of depression.ConclusionAn early psychiatric assessment may be helpful in improving psychological well-being in those with CHC, leading to adherence to PEG-IFN-based treatment.

Somatic pain associated with initiation of interferon-alpha (IFN-α) plus ribavirin (RBV) therapy in chronic HCV patients: A prospective study

“…The peak of somatic pain scores at 8th week may imply the cumulative result of stress response to chronic pain and contributed to the higher incidence of depressive episodes in the first 8 weeks of our study. Similarly, previous literature also reported a higher depression incidence in the first 8 weeks in HCV patients receiving IFN-α therapy ( Choi et al., 2017 ; Horikawa et al., 2003 ; Malaguarnera et al., 2001 ). Moreover, previous literature revealed a positive predictive effect of somatic pain, especially non-specific musculoskeletal complaints, on the occurrence of depression ( Gerber et al., 1992 ).…”

Dynamic Effects of Early Adolescent Stress on Depressive-Like Behaviors and Expression of Cytokines and JMJD3 in the Prefrontal Cortex and Hippocampus of Rats

“…Also, some patients suffering from chronic inflammatory diseases (e.g., cardiovascular diseases) had a higher incidence rate of depression ( 8 ). In addition, 50% of the hepatitis C patients receiving interferon-α (IFN-α, a pro-inflammatory cytokine) treatment had depressive symptoms ( 9 , 10 ). Our previous studies also suggested that both chronic mild stress in rats and the administration of lipopolysaccharides (LPS) in mice induced an increase in pro-inflammatory cytokines in the prefrontal cortex and hippocampus as well as depressive-like behaviors ( 11 , 12 ).…”

Biological and psychological components of depression in patients receiving IFN-alpha therapy for hepatitis C

“…This relationship is quite common in other studies on depression in which the initial severity of depressive symptoms was a strong predictor of depressive symptomatology. [23][24][25][26] Depressive symptoms in general seem to be the main predictor of depressive disorders and broad psychiatric and somatic symptomatology. A similar situation has been replicated in the present study -depressive symptoms, despite their origin, foreshadowed MDD in patients treated for hepatitis C. Moreover, the diagnosis of depression during treatment depended solely on the initial severity of depressive symptoms.…”