De novo depression and anxiety disorders and influence on adherence during peginterferon-alpha-2a and ribavirin treatment in patients with hepatitis C.
BACKGROUND
Depression and anxiety have been associated with interferon treatment and low treatment adherence.


OBJECTIVE
To study the incidence and associated risk factors of depressive and anxiety disorders during pegylated interferon plus ribavirin and treatment adherence in a prospective cohort of 176 patients with chronic hepatitis C patients.


METHODS
Patients were interviewed at baseline using the Structured Clinical Interview for DSM-IV Mental Disorders and the Patient Health Questionnaire and the Hospital Anxiety and Depression Scale were completed. Both questionnaires were completed also after 4, 12 and 24 weeks of treatment.


RESULTS
De novo depressive and/or anxiety disorders were diagnosed in 53 (36%) patients, in whom antidepressants and/or anxiolytics were administered. Higher baseline depression-subscale score (OR = 27.8, 95% CI = 2.82-333), primary education level (OR = 3.1, 95% CI = 1.40-7.03) and being an immigrant (OR = 3.2, 95% CI = 1.12-9.47) were predictors of psychiatric disorders during anti-viral therapy. The percentage of patients with good adherence was lower in those with depression and/or anxiety (79% vs. 90%, P < 0.04). Only one patient (1%) discontinued treatment because of a major depressive episode. Depression and/or anxiety disorders had no effect on attainment of sustained virological response.


CONCLUSIONS
Early detection and treatment of depressive and anxiety disorders favours good adherence to anti-viral treatment in hepatitis C.
Martín-Santos
R
R
Drug Abuse and Psychiatry Department, Hospital del Mar and Grup de Recerca Clínica en Farmacologia Humana i Neurociències, Unitat de Recerca Farmacològica, Institut Municipal d'Investigació Mèdica, Barcelona, Spain.
Díez-Quevedo
C
C
Castellví
P
P
Navinés
R
R
Miquel
M
M
Masnou
H
H
Soler
A
A
Ardevol
M
M
García
F
F
Galeras
J A
JA
Planas
R
R
Solà
R
R
D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000139:chemically induced / Q000821:virology; D016009:Chi-Square Distribution; D003863:Depression / Q000139:chemically induced / Q000821:virology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004359:Drug Therapy, Combination; D004522:Educational Status; D054242:Emigrants and Immigrants; D004651:Employment; D005260:Female; D016174:Hepacivirus; 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; D010349:Patient Compliance; D011092:Polyethylene Glycols / Q000009:adverse effects* / Q000627:therapeutic use; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011994:Recombinant Proteins; D012254:Ribavirin / Q000009:adverse effects* / Q000627:therapeutic use; D016896:Treatment Outcome
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a