DEPRESSIVE SYMPTOMS IN PATIENTS WITH HEPATITIS C TREATED WITH PEGYLATED INTERFERON ALPHA THERAPY: A 24-WEEK PROSPECTIVE STUDY

Objective: To prospectively evaluate depressive symptoms and risk factors for depression in patients with chronic hepatitis C (CHC) treated with pegylated interferon alpha therapy combined with oral ribavirin (PEG-IFN-alpha+RBV) and to analyze self-rating scale for depression in comparison to observer-based scale in the given population. Subjects and methods: The Hamilton Depression Rating Scale and Zung Self Rating Depression Scale were used to screen for depressive symptoms in 74 subjects with CHC before PEG- IFN-alpha (mean dose 152.6 +/- 25.6 mcg), and in the follow-up visits (4, 12 and 24 week). Results: Incidence of depressive symptoms in patients (mean age 39.9 +/- 13.4 years; equal sex distribution p=0.225) treated by PEG- IFN-alpha was the highest on 12th week of the treatment, when more than a 20% of our sample had moderate/severe symptoms of depression, and about 30% had minor depressive symptoms. For the screening of depression during PEG- IFN-alpha self-assessment scale was equally reliable as observer-based assesment of depressive symptoms. Common clinical parameters- subject related risk factors (age (p=0.9.55), sex (p=0.008), lifetime psychiatric disorder (p=0.656)), illness related risk factors (duration of CHC (p=0.267), i.v drug aplication as way of transmission (p=0.292)) and therapy-related risk factors (recommended duration of PEG-IFN-alpha (p=0.993) and dose of PEG-IFN-alpha (p=0.841)) were not signifcantly associated with depressive symptoms on PEG-IFN-alpha. Conclusions: Liason-consultation services should collaborate with hepatologists in creating screening programmes, supplemented by objective criteria and guidelines, for early recognition and treatment of interferon-induced depression.