Depression in hospitalized patients with malignant melanoma treated with interferon-alpha-2b: primary to induced disorders

Eur J Dermatol. 2009 Nov-Dec;19(6):611-5. doi: 10.1684/ejd.2009.0787. Epub 2009 Aug 26.

Abstract

Our objective was to study the clinical and management differences between primary and interferon (IFN)-induced depressive disorders in malignant melanoma patients visited by the consultation-liaison team during a two year period. This was a prospective study of 31 patients with malignant melanoma treated with IFN-alpha in a general teaching hospital. Clinical, psychiatric variables and DSM-IV-TR diagnosis were analyzed. The Clinical Global Impression Severity (CGI-S) and Improvement (CGI-I) of illness scales were administered at the time of consultation and at the end of hospitalization. The main diagnoses were depressive adjustment disorders in 14 patients (45.16%) followed by interferon-induced depressive disorders in 6 (19.36%). In patients with adjustment disorders, melanoma stage was significantly more advanced than in those with interferon-induced depressive disorder (p = 0.019). The latter scored higher in the CGI-S scale (p = 0.044) and in the CGI-I scale (p = 0.029). The interferon-induced depressive disorders, except one who required a reduction of IFN-alpha-2b dose, were successfully treated with antidepressant drugs. Clinical management and antidepressant treatment allowed the continuation of interferon therapy in malignant melanoma patients. Interferon-induced depression occurred in a few patients, which in turn were the most severe. Adjustment depressive disorder was the most common psychiatric diagnosis.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects*
  • Anxiety / chemically induced
  • Depression / chemically induced*
  • Depression / diagnosis
  • Depression / drug therapy
  • Depressive Disorder / chemically induced
  • Female
  • Hospitals, Teaching
  • Humans
  • Inpatients*
  • Interferon alpha-2
  • Interferon-alpha / administration & dosage
  • Interferon-alpha / adverse effects*
  • Male
  • Melanoma / complications
  • Melanoma / diagnosis
  • Melanoma / drug therapy*
  • Mental Disorders / chemically induced
  • Middle Aged
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Psychotropic Drugs / therapeutic use
  • Recombinant Proteins
  • Severity of Illness Index
  • Skin Neoplasms / complications
  • Skin Neoplasms / diagnosis
  • Skin Neoplasms / drug therapy*
  • Surveys and Questionnaires
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Interferon alpha-2
  • Interferon-alpha
  • Psychotropic Drugs
  • Recombinant Proteins