[Depressive symptoms during treatment with interferon alpha for HCV infection--preliminary report].
BACKGROUND
Interferon alpha, used in hepatitis C virus (HCV) infection causes many neuropsychiatric side effects: emotional disturbances, chronic fatigue, cognitive impairment, and psychotic states. They overlap with emotional disturbances and cognitive impairment caused by chronic HCV infection.


OBJECTIVE
To assess prevalence and severity of depressive symptoms in patients treated with interferon alpha due to HCV infection.


METHODS
A total of 44 persons (27 men, 17 women) aged from 21 to 61 years old (median 45 years) treated due to chronic hepatitis were examined. They were treated with pegylated interferon alfa 2a and ribavirin. All of them underwent liver biopsy to assess liver inflammation, fibrosis, and steatosis as well as completed Eysenck's neuroticism questionnaire. Then, before treatment and after 12 weeks, they underwent biochemical and psychiatric examination. Biochemical examination included aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (G-GT), and HCV RNA. Psychiatric examination included Beck Depression Inventory (BDI), Hamilton Depressive Rating Scale (HAMD), Montgomery-Asberg Depression Rating Scale (MADRS), and the SF-36 questionnaire. Diagnoses of depression were made basing on PSE questionnaire from Schedules of Clinical Assessment in Neuropsychiatry (SCAN version 2.0).


RESULTS
Depressive disorders were diagnosed in 3 (6.8%) subjects before treatment and in 5 (11.4%) subjects after 12 weeks of treatment. A statistically significant increase of depressive rates was observed (medians: HDRS 6/11.5; MADRS 4/10; BDI 8/10.5). Quality of life dropped significantly in some SF - 36 scales: physical functioning, general health, vitality, and social functioning. Depressive ratings were independent of biochemical parameters (AST, ALT, G-GT), HCV RNA, liver inflammation, fibrosis, steatosis level, and HCV genotype. Ratings of neuroticism highly influenced all depressive ratings. Rise of depressive ratings was independent of neither any initial biochemical parameters nor the neuroticism level.


CONCLUSIONS
Interferon alpha increases the severity of depressive symptoms. The rise is probably caused by biological activity of interferon and independent of initial ratings of depression.
Małyszczak
Krzysztof
K
Katedra i Klinika Psychiatrii AM we Wrocławiu.
Inglot
Małgorzata
M
Pawłowski
Tomasz
T
Czarnecki
Marcin
M
Rymer
Weronika
W
Andrzej
Kiejna
K
D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects*; D003863:Depression / Q000139:chemically induced* / Q000523:psychology; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000139:chemically induced; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage / Q000009:adverse effects*; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D012254:Ribavirin