Pegylated interferon and ribavirin-induced depression in chronic hepatitis C: role of personality

J Clin Psychiatry. 2009 Jun;70(6):817-28. doi: 10.4088/jcp.08m04230.

Abstract

Objective: Pegylated interferon (PegIFN) and ribavirin (RBV) treatment for the hepatitis C virus (HCV) infection can induce depressive episodes. Personality traits have been associated with mood disorders. The aim of this study was to evaluate the personality profile as a risk factor for induced depression by PegIFN and RBV treatment in patients with HCV.

Method: In a prospective cohort study, 204 consecutive HCV outpatients who received PegIFN and RBV were assessed using the Structured Clinical Interview for DSM-IV Axis I Disorders and the Temperament and Character Inventory-Revised (TCI-R). Moreover, the Patient Health Questionnaire and the Hospital Anxiety and Depression Scale were administered at baseline and at 4, 12, 24, and/or 48 weeks of treatment. Patients were recruited between September 2003 and December 2006.

Results: One hundred eighteen patients (57.8%) were men. The mean (SD) age was 44.39 (10.4) years. The incidence of induced depression during the 48 weeks of antiviral treatment was 73 (42%). Low self-directedness dimension (HR = 0.63, 95% CI = 0.446 to 0.890, p = .009), baseline subclinical depression levels (HR = 1.113, 95% CI = 1.023 to 1.22, p = .013), and history of mood disorders (HR = 0.372, 95% CI = 0.220 to 0.629, p <.001) were independent predictive factors for induced depression during PegIFN and RBV treatment. Other predictive personality TCI-R subscales were enlightened second nature (HR = 2.939, 95% CI = 1.423 to 6.071, p = .004), fatigability (HR = 0.421, 95% CI = 0.237 to 0.749, p = .01), and disorderliness (HR = 0.449, 95% CI = 0.248 to 0.815, p = .008).

Conclusion: Low self-directedness, depressive symptoms at baseline, and history of previous mood disorders may predict induced depression by PegIFN and RBV in euthymic HCV patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antiviral Agents / adverse effects*
  • Character*
  • Depressive Disorder / chemically induced*
  • Depressive Disorder / diagnosis
  • Depressive Disorder / psychology
  • Dose-Response Relationship, Drug
  • Female
  • Follow-Up Studies
  • Hepatitis C, Chronic / drug therapy*
  • Humans
  • Interferon alpha-2
  • Interferon-alpha / adverse effects*
  • Interferon-alpha / therapeutic use
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Personality Inventory / statistics & numerical data
  • Polyethylene Glycols / adverse effects*
  • Polyethylene Glycols / therapeutic use
  • Psychometrics
  • Recombinant Proteins
  • Risk Factors

Substances

  • Antiviral Agents
  • Interferon alpha-2
  • Interferon-alpha
  • Recombinant Proteins
  • Polyethylene Glycols
  • peginterferon alfa-2b
  • peginterferon alfa-2a