Subthreshold mania as predictor of depression during interferon treatment in HCV+ patients without current or lifetime psychiatric disorders

J Psychosom Res. 2007 Mar;62(3):349-55. doi: 10.1016/j.jpsychores.2006.10.024.

Abstract

Background: Depression is considered the most frequent interferon (IFN)-alpha-induced psychiatric disorder. However, other neuropsychiatric side effects of IFN treatment, such as irritability, anxiety, and manic episodes, are reported as well. We analyzed the impact of lifetime manic-hypomanic symptoms and anxiety on the development of depression in hepatitis-C-virus-infected subjects treated with two different types of IFN-alpha.

Methods: At baseline, subjects received thorough diagnostic assessment to exclude lifetime or current psychiatric symptoms. During treatment, subjects were administered interviewer-based and self-report instruments.

Results: Six (12%) of 49 individuals with a negative history of psychiatric disorders developed major depression during treatment with IFN. The onset of depression was significantly associated with the presence of lifetime subthreshold manic-hypomanic symptoms. Subjects exceeding manic threshold were more likely to develop depression than those below threshold (33.3% vs. 7.5%, P=.033).

Conclusions: Our data suggest that individuals treated with IFN with no past history of psychiatric disorders are more likely to develop depression if they experienced subthreshold manic-hypomanic symptoms in their lifetime. These findings derive from an exploratory study and may have important implications for the prevention of IFN-induced depression if replicated in larger studies.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Oral
  • Adult
  • Aged
  • Antiviral Agents / adverse effects*
  • Antiviral Agents / therapeutic use
  • Bipolar Disorder / diagnosis*
  • Bipolar Disorder / psychology
  • Depressive Disorder, Major / chemically induced*
  • Depressive Disorder, Major / diagnosis
  • Depressive Disorder, Major / psychology
  • Diagnostic and Statistical Manual of Mental Disorders
  • Drug Therapy, Combination
  • Female
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / psychology
  • Humans
  • Injections, Subcutaneous
  • Interferon alpha-2
  • Interferon-alpha / adverse effects*
  • Interferon-alpha / therapeutic use
  • Male
  • Middle Aged
  • Pilot Projects
  • Recombinant Proteins
  • Ribavirin / therapeutic use
  • Risk Factors
  • Statistics as Topic

Substances

  • Antiviral Agents
  • Interferon alpha-2
  • Interferon-alpha
  • Recombinant Proteins
  • Ribavirin