A Preliminary Study on the Relationship between Platelet Serotonin Transporter Functionality, Depression, and Fatigue in Patients with Untreated Chronic Hepatitis C.
Objective and Methods. Although the interaction between fatigue and depression in patients with chronic hepatitis C infection (HCV) has been recognized, the biological correlates of this observation have yet to be reported. We addressed this issue by examining serotonin transporter- (SERT-) driven [(14)C]-serotonin uptake rate (SUR) and serotonin content in platelets of 65 untreated HCV patients and 65 healthy control subjects (HCS). All patients completed report questionnaires for fatigue, depression, and general psychopathology. Structured interviews were conducted by a board-certified psychiatrist. Results. Whereas 36 of the patients experienced fatigue of moderate-to-severe intensity, only 16 reported symptoms of depression (BDI score > 10). Mean SUR in patients with depressive symptoms was significantly higher relative to the HCS, corresponding to a large Cohen's effect size of d = 1.45 (95% CI = 0.66-1.83). Patients who rated their fatigue to have a marked impact on mood and activity displayed a moderate relationship between the BDI score and SUR (n = 18, r = 0.563, P = 0.015), which becomes stronger after controlling for age, gender, and thrombocytopenia (r part = 0.710, P = 0.003). In the univariate analysis, high fatigue interference score, thrombocytopenia, and high SUR were all significant predictors of depression. Conclusions. High SERT activity could be implicated in the expression of depressive symptoms especially in a subgroup of HCV patients who are feeling fatigue as markedly distressing.
Charité University Medicine Berlin, CCM, Department of Psychiatry and Psychotherapy, 10117 Berlin, Germany.
Leonora
0000-0002-1970-1929
L
Franke
Charité University Medicine Berlin, CCM, Department of Medicine, Division of Psychosomatic Medicine and Psychotherapy, 10117 Berlin, Germany.
Eric
E
Therstappen
Augusta Victoria Hospital, Department of Infectiology and Gastroenterology and Hepatology, Berlin, Germany.
Beate
B
Schlosser
Leber- und Studienzentrum am Checkpoint Berlin, Germany.
Michael
M
Biermer
University Clinic Leipzig, Department of Hepatology, Clinic of Gastroenterology and Rheumatology, Leipzig, Germany.
Thomas
T
Berg
Department of Psychiatry and Psychotherapy, Kliniken Essen-Mitte, Essen, Germany.
Martin
M
Schäfer
University Hospital Hamburg-Eppendorf, Laboratory for Fetomaternal Medicine, Department of Obstetrics and Fetal Medicine, Hamburg, Germany.
Petra
P
Arck
Charité University Medicine Berlin, CCM, Department of Psychiatry and Psychotherapy, 10117 Berlin, Germany.
Ralf
R
Uebelhack
Ruhr University Bochum, Department of Psychiatry, LWL University Hospital, Bochum, Germany.
Astrid
A
Friebe