Risk factors for the development of depression in patients with hepatitis C taking interferon-α

Abstract

Interferon-α, currently used for the treatment of hepatitis C, is associated with a substantially elevated risk of depression. However, not everyone who takes this drug becomes depressed, so it is important to understand what particular factors may make some individuals more ‘at risk’ of developing depression than others. Currently there is no consensus as to why interferon-induced depression occurs and the range of putative risk factors is wide and diverse. The identification of risk factors prior to treatment may allow identification of patients who will become depressed on interferon, allowing the possibility of improved treatment support and rates of treatment adherence. Here, we consolidate and review the literature on risk factors, and we discuss the potential confounds within the research examined in order to better isolate the risk factors that may be important in the development of depression in these patients and which might help predict patients likely to become depressed on treatment. We suggest that interactions between psychobehavioral, genetic, and biological risk factors are of particular importance in the occurrence of depression in patients with hepatitis C taking interferon-α.

A Survey on the Prevalence of Depression in Blood Donors with Hepatitis C in Shiraz

“…Therefore, identification of the risk factors for the subsequent development of depression in HCV patients is necessary (28). Yet, physicians must consider the risk of depression particularly in the patients with a current or past history of depression, other psychiatric diseases, hospitalization for any psychiatric diseases, and suicide attempts before stating the treatment.…”

An Exploration of Depressive Symptoms in Hepatitis C Patients Taking Interferon-alpha: Increase in Sickness Behaviors but not Negative Cognitions

“…Negative cognitions are a key part of the depressive syndrome, 8 but are not a feature of sickness behavior. 9,10 The fact that IFN-a did not increase negative cognitions in this sample indicates that the behavioral syndrome we observed is due to sickness behaviors and could be different to an idiopathic depression. Support for this idea comes from the work of Pasquini et al 17 who found that an IFN-a-induced depression comprised significantly less negative cognitions than a primary depression.…”

“…8 Many of the symptoms of MDD are also the features of sickness behaviors, 9,10 with the main difference between these two syndromes being the presence of negative cognitions such as hopelessness, helplessness and worthlessness in MDD but not sickness behavior. The observation that sickness behaviors overlap considerably with symptoms of MDD has led to considerable interest in trying to understand the behavioral syndrome that accompanies IFN-a therapy.…”

Differential effects of opioid receptor modulators on motivational and stress-coping behaviors in the back-translational rat IFN-α depression model

“…The present work focuses on opioid receptor modulators in dysregulated motivational and stress coping behavior [13,14], using the clinically-relevant, back-translational, rat interferonalpha (IFN-α) depression model [15][16][17][18][19]. We employed a progressive ratio (PR) task reinforced with a natural reward (sucrose pellets) to examine motivated behavior, and the FST to assess stress-coping behavior.…”