Dell'Osso Liliana, Pini Stefano, Maggi Luca, Rucci Paola, Del Debbio Alessandro, Carlini Marina, Baldini Alessia, Ferrari Giuseppe, Manca Elena, Beverini Enrico, Amore Mario, Scarallo Vincenzo, Semeraro Quirico, Brunetto Maurizia, Bonino Ferruccio, Maj Mario
Department of Psychiatry, University of Pisa, Pisa, Italy.
J Psychosom Res. 2007 Mar;62(3):349-55. doi: 10.1016/j.jpsychores.2006.10.024.
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.
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.
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).
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.
抑郁症被认为是最常见的α-干扰素（IFN）诱发的精神障碍。然而，IFN治疗的其他神经精神副作用，如易怒、焦虑和躁狂发作，也有报道。我们分析了终生躁狂-轻躁狂症状和焦虑对接受两种不同类型α-干扰素治疗的丙型肝炎病毒感染受试者发生抑郁症的影响。
在基线时，受试者接受全面的诊断评估以排除终生或当前的精神症状。在治疗期间，对受试者使用基于访谈者和自我报告的工具。
49名无精神疾病史的个体中有6名（12%）在IFN治疗期间发生了重度抑郁症。抑郁症的发作与终生阈下躁狂-轻躁狂症状的存在显著相关。超过躁狂阈值的受试者比低于阈值的受试者更易发生抑郁症（33.3%对7.5%，P = 0.033）。
我们的数据表明，无精神疾病史的接受IFN治疗的个体，如果其一生中经历过阈下躁狂-轻躁狂症状，则更易发生抑郁症。这些发现来自一项探索性研究，如果在更大规模的研究中得到重复，可能对预防IFN诱发的抑郁症具有重要意义。
