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Factors influencing long‐term changes in mental health after interferon‐alpha treatment of chronic hepatitis C
Author(s) -
SCHMIDT F.,
JANSSEN G.,
MARTIN G.,
LORENZ R.,
LOESCHKE K.,
SOYKA M.,
FOLWACZNY C.,
SCHAEFER M.
Publication year - 2009
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2009.04123.x
Subject(s) - medicine , ribavirin , depression (economics) , psychiatry , hepatitis c , mental health , brief psychiatric rating scale , global assessment of functioning , rating scale , hepatitis c virus , immunology , schizophrenia (object oriented programming) , virus , psychology , psychosis , developmental psychology , economics , macroeconomics
Summary Background Antiviral treatment with interferon‐alpha (IFN‐α) is associated with several acute psychiatric side effects. Little is known about long‐term effects on mental health after treatment independent from viral response and the influence of pre‐existing psychiatric risk‐factors. Aim To evaluate long‐term effects of antiviral treatment with interferon‐alpha (IFN‐α) on mental health in patients with psychiatric risk factors. Method We prospectively investigated long‐term mental health changes in 81 hepatitis C virus‐infected patients. Psychiatric outcome was measured with the Montgomery–Asberg Depression Scale (MADRS), Brief Psychiatric Rating Scale, the Global Social Functioning Scale and the Global Clinical Impression Scale 6 months after the end of antiviral treatment with IFN‐α and ribavirin. Results Six months after antiviral therapy, 49% of the patients showed a worsening and 27.2% an improvement of depression scores. The most important predictor for a long‐term improvement of depression scores was a pre‐treatment MADRS score ≥5 (OR 14.21, 95% CI: 2.51–81.30). Patients with pre‐existing psychiatric disorders (OR = 0.117, 95% CI: 0.024–0.558), methadone substitution (OR = 0.20, 95% CI: 0.045–0.887) or genotype 2/3 (OR = 0.341, 95% CI: 0.138–0.845) were significantly less likely to show a long‐term worsening of depressive symptoms. Conclusions Pre‐existing psychiatric risk factors increase the chance for a long‐term improvement and reduce the risk for a long‐term worsening of mental health after antiviral treatment of chronic hepatitis C with IFN‐α.