title: Subthreshold mania as predictor of depression during interferon treatment in HCV+ patients without current or lifetime psychiatric disorders.
abstract: BACKGROUND
  Depression is considered the most frequent interferon (IFN)-alpha-induced psychiatric disorder. However, other neuropsychiatric side effects of IFN treatment, such as irritability, anxiety, and manic episodes, are reported as well. We analyzed the impact of lifetime manic-hypomanic symptoms and anxiety on the development of depression in hepatitis-C-virus-infected subjects treated with two different types of IFN-alpha.
  
  
  METHODS
  At baseline, subjects received thorough diagnostic assessment to exclude lifetime or current psychiatric symptoms. During treatment, subjects were administered interviewer-based and self-report instruments.
  
  
  RESULTS
  Six (12%) of 49 individuals with a negative history of psychiatric disorders developed major depression during treatment with IFN. The onset of depression was significantly associated with the presence of lifetime subthreshold manic-hypomanic symptoms. Subjects exceeding manic threshold were more likely to develop depression than those below threshold (33.3% vs. 7.5%, P=.033).
  
  
  CONCLUSIONS
  Our data suggest that individuals treated with IFN with no past history of psychiatric disorders are more likely to develop depression if they experienced subthreshold manic-hypomanic symptoms in their lifetime. These findings derive from an exploratory study and may have important implications for the prevention of IFN-induced depression if replicated in larger studies.
authors.affiliation: Department of Psychiatry, University of Pisa, Pisa, Italy.
authors.forename: Liliana
authors.initials: L
authors.lastname: Dell'Osso
authors.forename: Stefano
authors.initials: S
authors.lastname: Pini
authors.forename: Luca
authors.initials: L
authors.lastname: Maggi
authors.forename: Paola
authors.initials: P
authors.lastname: Rucci
authors.forename: Alessandro
authors.initials: A
authors.lastname: Del Debbio
authors.forename: Marina
authors.initials: M
authors.lastname: Carlini
authors.forename: Alessia
authors.initials: A
authors.lastname: Baldini
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ferrari
authors.forename: Elena
authors.initials: E
authors.lastname: Manca
authors.forename: Enrico
authors.initials: E
authors.lastname: Beverini
authors.forename: Mario
authors.initials: M
authors.lastname: Amore
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Scarallo
authors.forename: Quirico
authors.initials: Q
authors.lastname: Semeraro
authors.forename: Maurizia
authors.initials: M
authors.lastname: Brunetto
authors.forename: Ferruccio
authors.initials: F
authors.lastname: Bonino
authors.forename: Mario
authors.initials: M
authors.lastname: Maj
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000523:psychology; D003865:Major Depressive Disorder / Q000139:chemically induced* / Q000175:diagnosis / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D007279:Injections, Subcutaneous; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use; D012307:Risk Factors; D013223:Statistics as Topic
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D012254:Ribavirin