James Cook University, Queensland, Australia.
J Clin Nurs. 2011 May;20(9-10):1215-24. doi: 10.1111/j.1365-2702.2010.03494.x. Epub 2011 Mar 3.
The research literature was reviewed with the aim of answering the question 'is irritability an underappreciated side effect of interferon and ribavirin treatment for hepatitis C'.
The majority of information regarding interferon treatment identifies depression as the main psychological side effect. However, clinical observation and patient reports suggest that irritability, not depression, is the predominant side effect.
The literature review included research and discussion papers. Data bases were searched using the keywords interferon and hepatitis C in combination with one of the following: side effects, depression, mood alteration/change, irritability, anger, impulse control, psychiatric side effects or neuropsychiatric side effects.
The review revealed a gap in the literature regarding interferon-related irritability. Whereas depression was well researched and described, irritability was afforded little research time. However, where irritability was assessed, it was found to occur to a significant degree. Issues identified were difficulty defining and categorising irritability; lack of irritability-specific assessment tools and failure of depression rating scales to adequately discern irritable mood; and the confounding effect of physiological side effects on mood alteration. Relevance to clinical practice. Underappreciation and underrecognition of irritability have implications for clinical practice. Good research is the foundation for evidence-based practice; therefore, the possibility exists that, based on current research evidence, patients may not be receiving a standard care that adequately addresses the entirety of the side effect spectrum.
Irritability is an underappreciated psychological side effect of interferon therapy. Although irritability is recognised as a side effect of interferon, there is considerable discordance between clinical observation, patient reports and research evidence as reported in the literature.
本研究文献综述旨在回答“干扰素和利巴韦林治疗丙型肝炎的副作用是否被低估”这一问题。
大多数关于干扰素治疗的信息都将抑郁视为主要的心理副作用。然而，临床观察和患者报告表明，易激惹而不是抑郁是主要的副作用。
文献综述包括研究和讨论论文。使用干扰素和丙型肝炎作为关键词，结合以下关键词之一搜索数据库：副作用、抑郁、情绪改变/变化、易激惹、愤怒、冲动控制、精神副作用或神经精神副作用。
综述揭示了干扰素相关易激惹方面文献的空白。虽然抑郁已经得到了很好的研究和描述，但易激惹却很少得到研究。然而，在评估易激惹时，发现它确实发生在很大程度上。确定的问题包括难以定义和分类易激惹；缺乏易激惹特异性评估工具以及抑郁评定量表无法充分辨别易怒情绪；以及生理副作用对情绪改变的混杂影响。与临床实践的相关性。对易激惹的低估和认识不足对临床实践有影响。良好的研究是循证实践的基础；因此，根据目前的研究证据，患者可能无法得到充分解决副作用全貌的标准护理。
易激惹是干扰素治疗的一种被低估的心理副作用。尽管易激惹被认为是干扰素的副作用之一，但在文献中报告的临床观察、患者报告和研究证据之间存在相当大的不一致。
