Hepatitis C, alpha interferon, anxiety and depression disorders: A prospective study of 71 patients

Abstract

This article presents a prospective study of 71 patients infected with chronic viral hepatitis C and treated with interferon alpha during one year. The objective was to assess the incidence and predictive factors of anxiety and depression symptoms during and after the therapy. Each patient received psychiatric assessment before, during and after treatment, with evaluations using Hamilton-anxiety and MADRS scales. Results confirm the great incidence of depression and anxiety not only during interferon alpha therapy but also after treatment is discontinued. Sleep disorders and MADRS ratings of M4 seem to be predictive of the therapy's side effects. Thus, there seem to be easily discernable parameters allowing depression and suicidal behaviour to be anticipated. This paper emphasises their possible occurrence after the treatment and, therefore, the need for routine assessments after treatment is discontinued. Teams comprising both hepatologists and psychiatrists should complete these assessments. This shows the necessity of interdisciplinary collaboration treatment of this kind.

De novo depression and anxiety disorders and influence on adherence during peginterferon‐alpha‐2a and ribavirin treatment in patients with hepatitis C

“…On the other hand, there are no conclusive results in the literature supporting that a past history of major depressive disorder is a significant risk factor for the subsequent development of depression during IFN treatment. 17,[36][37][38][39][40][41][42] In agreement with Raison et al, 11 our data indicate that a previous history of major depression contributes to the risk of developing depressive symptoms during anti-viral therapy through an association with elevated baseline depression scores. Likewise, past history of substance abuse (opioid or alcohol dependence) was not predictive of the development of depressive syndromes during treatment in our sample.…”

“…11,12 The presence of depressive symptoms prior to IFN treatment seems to play a role as a risk factor for inducing depression during therapy, [13][14][15][16] but the occurrence of anxiety disorders before and during IFN treatment has been little investigated. 17 On the other hand, a previous study in which HCV genotype as a risk factor for depression was evaluated, no association was observed. 18 Recently, treatment with pegylated IFN (PegIFN) in combination with RBV has become the standard of care for patients with chronic hepatitis C. Pegylation involves the addition of a polyethylene glycol molecule to IFN-alpha.…”

Sex Differences in Depressive and Socioemotional Responses to an Inflammatory Challenge: Implications for Sex Differences in Depression

“…Some correlational work has found that the relationship between inflammatory markers and symptoms of depression or depressed mood is stronger in males than females (Gimeno et al, 2009;Penninx et al, 2003). Conversely, in the context of clinical studies that follow patients using the cytokine interferon-a (IFN-a), some work has found that females who receive IFN-a are at greater risk of developing depression than males (Gohier et al, 2003;Koskinas et al, 2003). Still, others have reported no sex differences in either correlational relationships between inflammation and depression (Bremmer et al, 2008) or in IFN-a-induced depression (Bonaccorso et al, 2002).…”

Prevalence and significance of neurocognitive dysfunction in hepatitis C in the absence of correlated risk factors

“…In addition, short-term neuropsychiatric complications are not uncommon in individuals with chronic HCV infection during treatment with interferon. [18][19][20] If participants are not screened thoroughly for these factors, the estimated prevalence of cognitive impairment associated with the virus per se may be inflated, particularly if such risk factors are more prevalent in the index population. In our study, the majority of consecutive cases presenting to the clinic (73% after eliminating refusals and individuals who did not meet age and linguistic competency criteria) had to be excluded for such reasons.…”