title: A longitudinal study evaluating the effects of interferon-alpha therapy on cognitive and psychiatric function in adults with chronic hepatitis C.
abstract: OBJECTIVE
  To prospectively evaluate for changes in objective cognitive performance (attention, memory, and executive function) and psychiatric symptom severity (depression, anxiety, fatigue, and pain) in patients before, during and after interferon-alpha based therapy (IFN) for chronic hepatitis C virus infection (HCV).
  
  
  METHODS
  33 HCV+ adults were evaluated two months before IFN initiation (baseline), three months into IFN, and six months following IFN termination (IFN+ Group). 31 HCV+ adults who did not undergo IFN therapy were evaluated at baseline and six months later (IFN- Group). At each evaluation, participants completed the Neuropsychological Assessment Battery (NAB) Attention, Memory and Executive Functions Modules, the Beck Depression Inventory, Second Edition (BDI), Generalized Anxiety Disorder Inventory (GADI), Fatigue Severity Scale (FSS), and Brief Pain Inventory (BPI).
  
  
  RESULTS
  Compared with the IFN- Group, the IFN+ Group experienced significantly (p<0.050) increased symptoms of depression, anxiety, fatigue and pain during IFN therapy relative to baseline. In the IFN+ Group, psychiatric symptoms generally returned to baseline levels following IFN termination. Sustained viral response was associated with significantly lower depression and fatigue. No significant changes in cognitive performance were observed.
  
  
  CONCLUSIONS
  During IFN, patients with HCV evidence significantly increased psychiatric symptoms, including symptoms of depression, anxiety, fatigue and pain. These psychiatric symptoms are generally short-term and remit following IFN termination, with increased benefit if viral clearance is achieved. However, IFN is not associated with significant declines in objective cognitive performance during or following IFN.
authors.affiliation: Research & Development Service, Portland VA Medical Center, 3710 SW U.S. Veterans Hospital Rd., Portland, OR 97239, USA; Mental Health and Clinical Neurosciences Division, Portland VA Medical Center, 3710 SW U.S. Veterans Hospital Rd., Portland, OR 97239, USA; Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, USA. Electronic address: marilyn.huckans@va.gov.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Huckans
authors.affiliation: Mental Health and Clinical Neurosciences Division, Portland VA Medical Center, 3710 SW U.S. Veterans Hospital Rd., Portland, OR 97239, USA; Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, USA.
authors.forename: Bret
authors.initials: B
authors.lastname: Fuller
authors.affiliation: Research & Development Service, Portland VA Medical Center, 3710 SW U.S. Veterans Hospital Rd., Portland, OR 97239, USA; School of Professional Psychology, Pacific University, 190 SE 8th Ave., Hillsboro, OR 97123, USA.
authors.forename: Viva
authors.initials: V
authors.lastname: Wheaton
authors.affiliation: Research & Development Service, Portland VA Medical Center, 3710 SW U.S. Veterans Hospital Rd., Portland, OR 97239, USA; School of Professional Psychology, Pacific University, 190 SE 8th Ave., Hillsboro, OR 97123, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Jaehnert
authors.affiliation: Research & Development Service, Portland VA Medical Center, 3710 SW U.S. Veterans Hospital Rd., Portland, OR 97239, USA; Graduate Department of Clinical Psychology, George Fox University, 414 N. Meridian St. #V104, Newberg, OR 97132, USA.
authors.forename: Carilyn
authors.initials: C
authors.lastname: Ellis
authors.affiliation: Research & Development Service, Portland VA Medical Center, 3710 SW U.S. Veterans Hospital Rd., Portland, OR 97239, USA; School of Professional Psychology, Pacific University, 190 SE 8th Ave., Hillsboro, OR 97123, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Kolessar
authors.affiliation: Research & Development Service, Portland VA Medical Center, 3710 SW U.S. Veterans Hospital Rd., Portland, OR 97239, USA; School of Professional Psychology, Pacific University, 190 SE 8th Ave., Hillsboro, OR 97123, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Kriz
authors.affiliation: Research & Development Service, Portland VA Medical Center, 3710 SW U.S. Veterans Hospital Rd., Portland, OR 97239, USA; School of Professional Psychology, Pacific University, 190 SE 8th Ave., Hillsboro, OR 97123, USA.
authors.forename: Jeanne Renee
authors.initials: JR
authors.lastname: Anderson
authors.affiliation: Research & Development Service, Portland VA Medical Center, 3710 SW U.S. Veterans Hospital Rd., Portland, OR 97239, USA; Graduate Department of Clinical Psychology, George Fox University, 414 N. Meridian St. #V104, Newberg, OR 97132, USA.
authors.forename: Kristin
authors.initials: K
authors.lastname: Berggren
authors.affiliation: Research & Development Service, Portland VA Medical Center, 3710 SW U.S. Veterans Hospital Rd., Portland, OR 97239, USA.
authors.forename: Hannah
authors.initials: H
authors.lastname: Olavarria
authors.affiliation: Gastroenterology Service, Portland VA Medical Center, 3710 SW US Veterans Hospital Rd., Portland, OR 97239, USA; Department of Internal Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland OR 97239, USA.
authors.forename: Anna W
authors.initials: AW
authors.lastname: Sasaki
authors.affiliation: Gastroenterology Service, Portland VA Medical Center, 3710 SW US Veterans Hospital Rd., Portland, OR 97239, USA; Department of Internal Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland OR 97239, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Chang
authors.affiliation: Portland Gastroenterology Division, Oregon Clinic, 9280 SE Sunnybrook Blvd., Clackamas, OR 97015, USA.
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Flora
authors.affiliation: Research & Development Service, Portland VA Medical Center, 3710 SW U.S. Veterans Hospital Rd., Portland, OR 97239, USA; Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, USA.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Loftis
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D001007:Anxiety / Q000209:etiology; D003071:Cognition / Q000187:drug effects; D015897:Comorbidity; D003863:Depression / Q000209:etiology; D005221:Fatigue / Q000209:etiology; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000523:psychology*; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage* / Q000009:adverse effects*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010146:Pain / Q000209:etiology; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D019562:Viral Load / Q000187:drug effects
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha
keywords: Anxiety; Cognition; Depression; Fatigue; Hepatitis C; Interferon; Pain