Background: Most physicians obtain psychiatric assessments in at-risk patients before prescribing interferon in chronic hepatitis C(HCV). The clinical impact of these assessments is not well characterized in clinic settings. Aims: This study was designed to evaluate the impact of pre treatment psychiatric evaluations and interventions on the treatment outcomes in a cohort of psychiatric-risk HCV patients. Method: Medical records of 119 HCV patients who were referred for pre therapy psychiatric evaluations were reviewed retrospectively. Reasons for referral, psychiatrists' diagnosis and recommendations were obtained. These data were correlated with viral, demographic and treatment data of individual patients. Results: Of the 119 patients, 61.3% were males. Mean age was 39.7 years (range 39.7-72.0). 73.9% were past intravenous drug users. 4.2% were of Asian origin. Genotype 1 accounted for 32.7%. 68.7% of treated patients were treated with pegyated interferon and ribavirin. 26.9% had a suspected current psychiatric symptom or illness which led to the referral. 63.9% had only a past psychiatric illness. 9.2% were referred as a routine. Most common reason for referral was either current or past history of depression (21.8% and 57.1% respectively). Current or past anxiety was present in 5% and 10.1% patients. Past history of psychosis present in 8.4% in patients. 40.6% of patients who were referred as having current psychiatric illness had a formal current psychiatric diagnosis at the psychiatric consultation. Only 25% of patients with past psychiatric illness had a formal current psychiatric diagnosis. Overall 72.3% had no current psychiatric condition. The common psychiatric condition diagnosed was depression at 13.2% followed by anxiety 4.2%. 26.9% were recommended to have regular psychiatric follow ups. 9.2% were prescribed anti psychiatric medications. 6.7%were recommended to defer their HCV therapy. Table 1 Conclusions: HCV patients with current psychiatric diagnosis had significantly higher number of psychiatric side effects and psychiatric interventions. But they could be treated without significant reduction in SVR rates. Table1: Treatment Outcomes