Interferon-related Depression in Hepatitis C Patients: Predictive Value of Bio-psycho-social Factors

Abstract

Introduction Interferon-related depressive disorders are well known in literature. Despite this, few study have been able to identify reliable predictors of depression Aims Our aim was to examine the predictive value of several bio-psycho-social factors for the development of persistent clinically significant depression in patients affected by HCV treated with IFN. We also aimed at describing the clinical course, treatment and impact on quality of life of depression. Methods We conducted a cohort prospective study with assessments at baseline and at 4, 8, and 24 weeks with clinical interview and self-administered psychometric tests. We evaluated depressive symptoms with the Hamilton Depression Rating Scale, manic symptoms, anxiety, suicidal ideation, temperament, alexithymia and quality of life with other reliable instruments. Results Preliminary results are available for 61 patients. Depressive symptoms increased significantly during IFN therapy to peak after 4 weeks. A third of patients still suffered clinically significant symptoms after six months. In a multivariate model, the onset of irritability (aOR= 6.5; p=0.03) and living alone (aOR= 7.4; p=0,06) predicted the persistence of depression after 6 months. The preliminary model displayed good levels of specificity and sensitivity. Conclusions Both psychological traits (irritability) and social factors (living alone) predicted the persistence of depression. These findings might prove useful to improve early detection of vulnerable patients and their mental health care in the real clinical world. Larger samples are however needed to confirm these findings.