[Treatment of affective disorder in hepatitis C. A prospective study in 50 patients].
Hepatitis C represents a major public health challenge due to its chronic course and major complications (e.g. liver tumor and cirrhosis). New treatment strategies (pegylated interferon +/- ribavirin) have recently improved the prognosis except in case of poor compliance. Psychiatric comorbidity, especially affective disorders, is commonly associated with hepatitis C and constitutes the main cause of poor compliance and treatment contraindication. The primary aim of our study was to emphasize the utility of a multi-disciplinary approach including psychiatric evaluation and preventive follow-up. The secondary objective was to show that a previous history of depression or attempted suicide should not be considered as a formal contraindication prohibiting the implementation of a specific follow-up. Fifty interferon treated patients were included in a prospective study: 20 were seen in an emergency setting in a context of anxiety or major depressive disorders after the initiation of the interferon treatment and 30 were followed on a systematic basis prior to the initiation of the interferon treatment. Our data confirm the high rate (52%) of major depressive disorders among the population of hepatitis C treated patients. A previous history of alcoholism might be predictive of such a complication. According to the subjective feeling of patients with previous break'off treatment associated with major depressive disorders, specific psychiatric follow-up may improve tolerance for the treatment. In conclusion, a previous history of depressive disorder or attempted suicide should not be considered as a contraindication, but should imply a specific psychiatric follow-up especially when alcoholism and previous break'off treatment are reported.
Lang
Jean-Philippe
JP
Pôle Référence VHC de Strasbourg, Etablissement Public de Santé Alsace-Nord, 67720 Hoerdt. jean-philippe.lang@ch-espan.fr
Michel
Laurent
L
Halleguen
Olivier
O
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006526:Hepatitis C / Q000150:complications* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D011446:Prospective Studies; D011795:Surveys and Questionnaires