HEPATIITTI/INTERFERONIHOITO

[Bb]

Lähettäjä: Soijuv Lähetetty: 11.2.2005 8:18

Interferonihoidosta seuraa aika usein depressiota. Seuraavassa tutkimuksessa 185 potilaasta 31:llä ilmeni psykiatrisia ongelmia. Interferonia annetaan mm. hepatiitti C:n hoitoon. Hepatiittia esiintyy toisinaan myös borrelioosia sairastavilla kuten aiemmin lähettämissäni artikkeleissa on todettu:


Interferon-induced depression: prevalence and management

A. Scaloria, 1, M. Pozzia, V. Belliab, P. Apalec, G. Santamariad, T. Bordonid, A. Redaellia, A. Avoliob, P. Parravicinib, P. Pioltellia and L. Roffia, b, Corresponding Author Contact Information, E-mail The Corresponding Author

aDepartment of Medicine, University of Milano-Bicocca, S. Gerardo Hospital, Monza, Italy
bDepartment of Medicine, Ospedale Civile, Via Stelvio 25, 23100 Sondrio, Italy
cDepartment of Neurology, University of Milano-Bicocca, S. Gerardo Hospital, Monza, Italy
dDepartment of Psychiatry, Ospedale Civile, Sondrio, Italy

Received 1 January 2004; accepted 13 September 2004. Available online 18 November 2004.

Abstract

Background.

Interferon-induced depression ranges from 0 to 50%. Interferon schedule and a history of psychiatric illnesses are not enough to predict who will develop symptoms and who will not.

Aims.

To assess the prevalence of depression during interferon therapy; to test whether Minnesota Multiphasic Personality Inventory is useful in clinical practice for the early identification of patients at risk of depression; whether and how the depression can be cured.

Patients.

One hundred and eighty-five patients treated with interferon and ribavirin for chronic hepatitis C.

Methods.

Before therapy, all patients underwent a Minnesota Multiphasic Personality Inventory and a clinical examination, specifically for the identification of depressive symptoms.

Results.

Thirty-one patients developed a psychiatric disorder, 11 of them requiring treatment with anti-depressant drugs. Among the 18 patients with Minnesota Multiphasic Personality Inventory positive tests, 16 developed a psychiatric disorder, 8 of them a severe disorder (sensitivity of 0.58; 0.73 for severe disorders).

Among the 154 who did not develop psychiatric side effects, 152 had a negative Minnesota Multiphasic Personality Inventory (specificity: 0.99). Severe psychiatric disorders were successfully treated with anti-depressant drugs.

Conclusions.

Psychiatric side effects are easy to see during interferon therapy. A psychiatric evaluation should be considered on all patients before treatment. If depression develops, it should be treated aggressively, and selective serotonin re-uptake inhibitors are the anti-depressants of choice.

Keywords: Chronic hepatitis C; Depression; Interferon therapy

Abbreviations: IFN, interferon; MMPI, Minnesota Multiphasic Personality Inventory; SSRIs, selective serotonin re-uptake inhibitors

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