title: Suicidal ideation during interferon-alpha2b and ribavirin treatment of patients with chronic hepatitis C.
abstract: Psychiatric and substance use disorders affect most patients with chronic hepatitis C and are the most common reasons for exclusion from antiviral therapies. Suicidal ideation (SI) is often cited as a reason to exclude patients from interferon-based treatment or to terminate antiviral treatment that is in progress. This study examines SI in hepatitis C patients untreated and treated with interferon-alpha2b, a medication commonly associated with depression. Fifty-five subjects with chronic hepatitis C were followed for 24 weeks with three measures of depression, each containing one item assessing SI. A total of 15/55 (27%) subjects reported SI while not on interferon therapy. Of the 42 patients treated with interferon, 18 (43%) endorsed SI at some point during antiviral treatment. However, 17/18 (94%) finished at least a 6-month course of interferon therapy. No subjects attempted suicide. Although SI in some form is common in hepatitis C patients, in most cases it is mild in nature. With adequate support most patients can successfully complete a full course of antiviral treatment.
authors.affiliation: Department of Medicine, Veterans Affairs Medical Center, Minneapolis, MN, USA. eric.dieperink@med.va.gov
authors.forename: Eric
authors.initials: E
authors.lastname: Dieperink
authors.forename: Samuel B
authors.initials: SB
authors.lastname: Ho
authors.forename: Lori
authors.initials: L
authors.lastname: Tetrick
authors.forename: Paul
authors.initials: P
authors.lastname: Thuras
authors.forename: Kulwinder
authors.initials: K
authors.lastname: Dua
authors.forename: Mark L
authors.initials: ML
authors.lastname: Willenbring
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000075202:Contraindications; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D005500:Follow-Up Studies; D006297:Health Services Accessibility; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000523:psychology*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D011569:Psychiatric Status Rating Scales; D011994:Recombinant Proteins; D020280:Sertraline / Q000627:therapeutic use; D019966:Substance-Related Disorders / Q000523:psychology; D013405:Suicide / Q000523:psychology*; D014728:Veterans / Q000523:psychology; D014922:Wisconsin
chemical_list: D044966:Anti-Retroviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D020280:Sertraline