Orrù M Germana, Baita Antonella, Sitzia Rossella, Costa Alessandra, Muntoni Elisabetta, Landau Sabine, Chessa Luchino, Farci M Giulia, Carpiniello Bernardo, Pariante Carmine M
Clinica Psichiatrica, Università degli Studi di Cagliari, Cagliari, Italy.
Epidemiol Psichiatr Soc. 2005 Jul-Sep;14(3):145-53. doi: 10.1017/s1121189x00006394.
Patients with chronic viral hepatitis suffer from a high prevalence of psychiatric problems. Furthermore, the treatment for chronic viral hepatitis, with interferon (IFN) alpha, induces the occurrence of further psychopathological symptoms. The authors examined whether patients with a pre-existing psychiatric diagnosis had more severe IFN alpha-induced psychiatric adverse effects, and whether they were more likely to interrupt the IFN alpha therapy, compared with control patients with no pre-existing psychiatric diagnosis. They also examined the psychopharmacological management of the interferon-alpha-induced psychiatric side effects.
The authors studied prospectively 60 patients with chronic hepatitis B or C in Cagliari, Italy. Patients underwent psychiatric assessment before starting interferon alpha and monthly throughout the therapy.
After adjusting for the baseline psychopathology, there was no statistically significant difference in interferon-alpha-induced psychiatric adverse effects between patients with a pre-existing psychiatric diagnosis and controls. There was also no evidence that psychiatric cases were more likely than controls to interrupt the IFN alpha therapy because of psychiatric side effects. Moreover, there was no difference in the psychiatric adverse effects severe enough to require psychopharmacological treatment. Finally, psychopharmacological management successfully treated psychiatric symptoms induced by the IFN alpha.
Patients with a pre-existing psychiatric diagnosis do not have a specific vulnerability to interferon-alpha-induced psychiatric adverse effects.
慢性病毒性肝炎患者存在较高的精神问题患病率。此外，使用α干扰素治疗慢性病毒性肝炎会引发更多精神病理症状。作者研究了与无既往精神疾病诊断的对照患者相比，有既往精神疾病诊断的患者是否会出现更严重的α干扰素诱导的精神不良反应，以及他们是否更有可能中断α干扰素治疗。他们还研究了α干扰素诱导的精神副作用的心理药物治疗。
作者对意大利卡利亚里的60例慢性乙型或丙型肝炎患者进行了前瞻性研究。患者在开始使用α干扰素前及整个治疗过程中每月接受一次精神评估。
在对基线精神病理学进行调整后，有既往精神疾病诊断的患者与对照组在α干扰素诱导的精神不良反应方面无统计学显著差异。也没有证据表明精神疾病患者因精神副作用而比对照组更有可能中断α干扰素治疗。此外，在严重到需要心理药物治疗的精神不良反应方面没有差异。最后，心理药物治疗成功地治疗了α干扰素诱导的精神症状。
有既往精神疾病诊断的患者对α干扰素诱导的精神不良反应没有特殊易感性。
