Pegylated interferon and ribavirin-induced depression in chronic hepatitis C: role of personality.
OBJECTIVE
Pegylated interferon (PegIFN) and ribavirin (RBV) treatment for the hepatitis C virus (HCV) infection can induce depressive episodes. Personality traits have been associated with mood disorders. The aim of this study was to evaluate the personality profile as a risk factor for induced depression by PegIFN and RBV treatment in patients with HCV.


METHODS
In a prospective cohort study, 204 consecutive HCV outpatients who received PegIFN and RBV were assessed using the Structured Clinical Interview for DSM-IV Axis I Disorders and the Temperament and Character Inventory-Revised (TCI-R). Moreover, the Patient Health Questionnaire and the Hospital Anxiety and Depression Scale were administered at baseline and at 4, 12, 24, and/or 48 weeks of treatment. Patients were recruited between September 2003 and December 2006.


RESULTS
One hundred eighteen patients (57.8%) were men. The mean (SD) age was 44.39 (10.4) years. The incidence of induced depression during the 48 weeks of antiviral treatment was 73 (42%). Low self-directedness dimension (HR = 0.63, 95% CI = 0.446 to 0.890, p = .009), baseline subclinical depression levels (HR = 1.113, 95% CI = 1.023 to 1.22, p = .013), and history of mood disorders (HR = 0.372, 95% CI = 0.220 to 0.629, p <.001) were independent predictive factors for induced depression during PegIFN and RBV treatment. Other predictive personality TCI-R subscales were enlightened second nature (HR = 2.939, 95% CI = 1.423 to 6.071, p = .004), fatigability (HR = 0.421, 95% CI = 0.237 to 0.749, p = .01), and disorderliness (HR = 0.449, 95% CI = 0.248 to 0.815, p = .008).


CONCLUSIONS
Low self-directedness, depressive symptoms at baseline, and history of previous mood disorders may predict induced depression by PegIFN and RBV in euthymic HCV patients.
Castellvi
Pere
P
Universitat Autònoma de Barcelona. [corrected]
Navinés
Ricard
R
Gutierrez
Fernando
F
Jiménez
Dolors
D
Márquez
Carme
C
Subirà
Susana
S
Solà
Ricard
R
Martín-Santos
Rocío
R
D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects*; D002605:Character; D003866:Depressive Disorder / Q000139:chemically induced* / Q000175:diagnosis / Q000523:psychology; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010555:Personality Inventory / Q000706:statistics & numerical data; D011092:Polyethylene Glycols / Q000009:adverse effects* / Q000627:therapeutic use; D011594:Psychometrics; D011994:Recombinant Proteins; D012307:Risk Factors
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a