Depression in hospitalized patients with malignant melanoma treated with interferon-alpha-2b: primary to induced disorders.
Our objective was to study the clinical and management differences between primary and interferon (IFN)-induced depressive disorders in malignant melanoma patients visited by the consultation-liaison team during a two year period. This was a prospective study of 31 patients with malignant melanoma treated with IFN-alpha in a general teaching hospital. Clinical, psychiatric variables and DSM-IV-TR diagnosis were analyzed. The Clinical Global Impression Severity (CGI-S) and Improvement (CGI-I) of illness scales were administered at the time of consultation and at the end of hospitalization. The main diagnoses were depressive adjustment disorders in 14 patients (45.16%) followed by interferon-induced depressive disorders in 6 (19.36%). In patients with adjustment disorders, melanoma stage was significantly more advanced than in those with interferon-induced depressive disorder (p = 0.019). The latter scored higher in the CGI-S scale (p = 0.044) and in the CGI-I scale (p = 0.029). The interferon-induced depressive disorders, except one who required a reduction of IFN-alpha-2b dose, were successfully treated with antidepressant drugs. Clinical management and antidepressant treatment allowed the continuation of interferon therapy in malignant melanoma patients. Interferon-induced depression occurred in a few patients, which in turn were the most severe. Adjustment depressive disorder was the most common psychiatric diagnosis.
Navinés
Ricard
R
Unitat de Recerca Farmacològica, Institut Municipal d'Investigació Mèdica, Doctor Aiguader 88, E-08003, Barcelona, Spain. rnavines@hotmail.com
Gómez-Gil
Esther
E
Puig
Susana
S
Baeza
Inmaculada
I
De Pablo
Joan
J
Martín-Santos
Rocío
R
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001007:Anxiety / Q000139:chemically induced; D003863:Depression / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D003866:Depressive Disorder / Q000139:chemically induced; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007297:Inpatients; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008545:Melanoma / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D001523:Mental Disorders / Q000139:chemically induced; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011619:Psychotropic Drugs / Q000627:therapeutic use; D011994:Recombinant Proteins; D012720:Severity of Illness Index; D012878:Skin Neoplasms / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011619:Psychotropic Drugs; D011994:Recombinant Proteins