Interferon-induced depression: prevalence and management.
BACKGROUND
Interferon-induced depression ranges from 0 to 50%. Interferon schedule and a history of psychiatric illnesses are not enough to predict who will develop symptoms and who will not.


OBJECTIVE
To assess the prevalence of depression during interferon therapy; to test whether Minnesota Multiphasic Personality Inventory is useful in clinical practice for the early identification of patients at risk of depression; whether and how the depression can be cured.


METHODS
One hundred and eighty-five patients treated with interferon and ribavirin for chronic hepatitis C.


METHODS
Before therapy, all patients underwent a Minnesota Multiphasic Personality Inventory and a clinical examination, specifically for the identification of depressive symptoms.


RESULTS
Thirty-one patients developed a psychiatric disorder, 11 of them requiring treatment with anti-depressant drugs. Among the 18 patients with Minnesota Multiphasic Personality Inventory positive tests, 16 developed a psychiatric disorder, 8 of them a severe disorder (sensitivity of 0.58; 0.73 for severe disorders). Among the 154 who did not develop psychiatric side effects, 152 had a negative Minnesota Multiphasic Personality Inventory (specificity: 0.99). Severe psychiatric disorders were successfully treated with anti-depressant drugs.


CONCLUSIONS
Psychiatric side effects are easy to see during interferon therapy. A psychiatric evaluation should be considered on all patients before treatment. If depression develops, it should be treated aggressively, and selective serotonin re-uptake inhibitors are the anti-depressants of choice.
Scalori
A
A
Department of Medicine, University of Milano-Bicocca, S. Gerardo Hospital, Monza, Italy.
Pozzi
M
M
Bellia
V
V
Apale
P
P
Santamaria
G
G
Bordoni
T
T
Redaelli
A
A
Avolio
A
A
Parravicini
P
P
Pioltelli
P
P
Roffi
L
L
D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use; D003863:Depression / Q000139:chemically induced* / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D007372:Interferons / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012196:Review Literature as Topic; D012254:Ribavirin / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D016896:Treatment Outcome
D000998:Antiviral Agents; D007372:Interferons; D012254:Ribavirin; D017367:Selective Serotonin Reuptake Inhibitors