Małyszczak Krzysztof, Inglot Małgorzata, Pawłowski Tomasz, Czarnecki Marcin, Rymer Weronika, Andrzej Kiejna
Katedra i Klinika Psychiatrii AM we Wrocławiu.
Psychiatr Pol. 2006 Jul-Aug;40(4):799-808.
Interferon alpha, used in hepatitis C virus (HCV) infection causes many neuropsychiatric side effects: emotional disturbances, chronic fatigue, cognitive impairment, and psychotic states. They overlap with emotional disturbances and cognitive impairment caused by chronic HCV infection.
To assess prevalence and severity of depressive symptoms in patients treated with interferon alpha due to HCV infection.
A total of 44 persons (27 men, 17 women) aged from 21 to 61 years old (median 45 years) treated due to chronic hepatitis were examined. They were treated with pegylated interferon alfa 2a and ribavirin. All of them underwent liver biopsy to assess liver inflammation, fibrosis, and steatosis as well as completed Eysenck's neuroticism questionnaire. Then, before treatment and after 12 weeks, they underwent biochemical and psychiatric examination. Biochemical examination included aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (G-GT), and HCV RNA. Psychiatric examination included Beck Depression Inventory (BDI), Hamilton Depressive Rating Scale (HAMD), Montgomery-Asberg Depression Rating Scale (MADRS), and the SF-36 questionnaire. Diagnoses of depression were made basing on PSE questionnaire from Schedules of Clinical Assessment in Neuropsychiatry (SCAN version 2.0).
Depressive disorders were diagnosed in 3 (6.8%) subjects before treatment and in 5 (11.4%) subjects after 12 weeks of treatment. A statistically significant increase of depressive rates was observed (medians: HDRS 6/11.5; MADRS 4/10; BDI 8/10.5). Quality of life dropped significantly in some SF - 36 scales: physical functioning, general health, vitality, and social functioning. Depressive ratings were independent of biochemical parameters (AST, ALT, G-GT), HCV RNA, liver inflammation, fibrosis, steatosis level, and HCV genotype. Ratings of neuroticism highly influenced all depressive ratings. Rise of depressive ratings was independent of neither any initial biochemical parameters nor the neuroticism level.
Interferon alpha increases the severity of depressive symptoms. The rise is probably caused by biological activity of interferon and independent of initial ratings of depression.
用于治疗丙型肝炎病毒（HCV）感染的α干扰素会引发许多神经精神方面的副作用：情绪障碍、慢性疲劳、认知障碍和精神状态异常。这些副作用与慢性HCV感染所导致的情绪障碍和认知障碍相互重叠。
评估因HCV感染而接受α干扰素治疗的患者中抑郁症状的患病率及严重程度。
共对44名年龄在21至61岁（中位数45岁）因慢性肝炎接受治疗的患者（27名男性，17名女性）进行了检查。他们接受聚乙二醇化α-2a干扰素和利巴韦林治疗。所有患者均接受肝脏活检以评估肝脏炎症、纤维化和脂肪变性情况，并完成艾森克神经质问卷。然后，在治疗前和治疗12周后，他们接受了生化和精神科检查。生化检查包括天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）、γ-谷氨酰转肽酶（G-GT）和HCV RNA。精神科检查包括贝克抑郁量表（BDI）、汉密尔顿抑郁评定量表（HAMD）、蒙哥马利-阿斯伯格抑郁评定量表（MADRS）和SF-36问卷。根据神经精神病临床评估日程表（SCAN版本2.0）中的PSE问卷进行抑郁症诊断。
治疗前3名（6.8%）受试者被诊断为抑郁症，治疗12周后5名（11.4%）受试者被诊断为抑郁症。观察到抑郁率有统计学意义的升高（中位数：HDRS 6/11.5；MADRS 4/10；BDI 8/10.5）。在SF-36量表的某些方面，生活质量显著下降：身体功能、总体健康、活力和社会功能。抑郁评分与生化参数（AST、ALT、G-GT）、HCV RNA、肝脏炎症、纤维化、脂肪变性程度及HCV基因型无关。神经质评分对所有抑郁评分有高度影响。抑郁评分的升高既不依赖于任何初始生化参数，也不依赖于神经质水平。
α干扰素会加重抑郁症状的严重程度。这种加重可能是由干扰素的生物活性引起的，且与初始抑郁评分无关。
