title: Factors influencing long-term changes in mental health after interferon-alpha treatment of chronic hepatitis C.
abstract: BACKGROUND
  Antiviral treatment with interferon-alpha (IFN-alpha) is associated with several acute psychiatric side effects. Little is known about long-term effects on mental health after treatment independent from viral response and the influence of pre-existing psychiatric risk-factors.
  
  
  OBJECTIVE
  To evaluate long-term effects of antiviral treatment with interferon-alpha (IFN-alpha) on mental health in patients with psychiatric risk factors.
  
  
  METHODS
  We prospectively investigated long-term mental health changes in 81 hepatitis C virus-infected patients. Psychiatric outcome was measured with the Montgomery-Asberg Depression Scale (MADRS), Brief Psychiatric Rating Scale, the Global Social Functioning Scale and the Global Clinical Impression Scale 6 months after the end of antiviral treatment with IFN-alpha and ribavirin.
  
  
  RESULTS
  Six months after antiviral therapy, 49% of the patients showed a worsening and 27.2% an improvement of depression scores. The most important predictor for a long-term improvement of depression scores was a pre-treatment MADRS score > or =5 (OR 14.21, 95% CI: 2.51-81.30). Patients with pre-existing psychiatric disorders (OR = 0.117, 95% CI: 0.024-0.558), methadone substitution (OR = 0.20, 95% CI: 0.045-0.887) or genotype 2/3 (OR = 0.341, 95% CI: 0.138-0.845) were significantly less likely to show a long-term worsening of depressive symptoms.
  
  
  CONCLUSIONS
  Pre-existing psychiatric risk factors increase the chance for a long-term improvement and reduce the risk for a long-term worsening of mental health after antiviral treatment of chronic hepatitis C with IFN-alpha.
authors.affiliation: Department of Psychiatry, Ludwig-Maximilians University, Munich, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Schmidt
authors.forename: G
authors.initials: G
authors.lastname: Janssen
authors.forename: G
authors.initials: G
authors.lastname: Martin
authors.forename: R
authors.initials: R
authors.lastname: Lorenz
authors.forename: K
authors.initials: K
authors.lastname: Loeschke
authors.forename: M
authors.initials: M
authors.lastname: Soyka
authors.forename: C
authors.initials: C
authors.lastname: Folwaczny
authors.forename: M
authors.initials: M
authors.lastname: Schaefer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D001523:Mental Disorders / Q000139:chemically induced; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012254:Ribavirin / Q000009:adverse effects* / Q000627:therapeutic use; D012307:Risk Factors; D012720:Severity of Illness Index; D013995:Time; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D012254:Ribavirin