title: Association of chronic hepatitis C with major depressive disorders: irrespective of interferon-alpha therapy.
abstract: BACKGROUND
  Mood and anxiety symptoms in chronic hepatitis C (CHC) may be related to the patient awareness of the diagnosis and prognosis, to side effects induced by interferon (IFN)-alpha treatment, as well as to substance abuse. However, the observation of metabolic alterations in patients with CHC has led to hypothesize a direct effect of hepatitis C virus (HCV) on brain function. This study was aimed at elucidating whether CHC is associated with specific anxiety or mood disorders independently of confounding factors.
  
  
  METHODS
  Patient cohort: consecutive patients, 135 with CHC and 76 with chronic hepatitis B (CHB).
  
  
  METHODS
  previous treatment with IFN-alpha, co-infection with HCV and hepatitis B virus, infection with human immunodeficiency virus, drug or alcohol abuse, or malignancies.
  
  
  METHODS
  subjects without evidence of hepatitis randomly extracted from the database of a previous epidemiological study; they were divided into two groups of 540 (332 males) and 304 (220 males) as controls for patients with CHC and CHB, respectively. The psychiatric diagnosis was formulated by means of the Composite International Diagnostic Interview Simplified carried out by a physician according to DSM-IV criteria.
  
  
  RESULTS
  A higher lifetime prevalence of major depressive disorder (MDD) was observed among CHC compared to CHB or controls. The risk of MDD was not statistically different between CHB and controls. Both the CHC and CHB groups showed a significantly higher frequency of panic disorder when compared to controls. No statistical differences were observed in the prevalence of general anxiety disorder and social phobia when CHC or CHB were compared to controls.
  
  
  CONCLUSIONS
  The present study provides the first evidence of an association between CHC and MDD, diagnosed on the basis of well-defined international criteria. This association is independent of treatment with IFN-alpha and is not influenced by substance or alcohol abuse. By contrast, anxiety disorders do not appear to be specifically associated with CHC.
authors.affiliation: Department of Public Health, University of Cagliari, Italy. mgcarta@tiscali.it.
authors.forename: Mauro G
authors.initials: MG
authors.lastname: Carta
authors.forename: Maria Carolina
authors.initials: MC
authors.lastname: Hardoy
authors.forename: Alessandra
authors.initials: A
authors.lastname: Garofalo
authors.forename: Enrica
authors.initials: E
authors.lastname: Pisano
authors.forename: Valentina
authors.initials: V
authors.lastname: Nonnoi
authors.forename: Gesuina
authors.initials: G
authors.lastname: Intilla
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Serra
authors.forename: Cinzia
authors.initials: C
authors.lastname: Balestrieri
authors.forename: Luchino
authors.initials: L
authors.lastname: Chessa
authors.forename: Cristiana
authors.initials: C
authors.lastname: Cauli
authors.forename: Maria Eliana
authors.initials: ME
authors.lastname: Lai
authors.forename: Patrizia
authors.initials: P
authors.lastname: Farci