Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy.
Psychiatry Unit, Department of Medical Sciences, University of Foggia, Italy.
Asian J Psychiatr. 2017 Apr;26:24-28. doi: 10.1016/j.ajp.2017.01.001. Epub 2017 Jan 10.
The aim of this study is to examine the role of different bio-psycho-social risk factors for the onset of depression among patients with Hepatitis C (HCV) treated with Interferon alpha (IFN).
Patients with HCV were recruited and assessed prospectively at baseline and after 4, 8, and 24 weeks since the start of IFN treatment. Assessments included the Hamilton Depression and Anxiety Rating Scales (HAM-D and HAM-A), Toronto Alexithymia Scale, Temperament Evaluation of the Memphis, Pisa, Paris and San Diego, 110 item version (TEMPS-A), Young Mania Rating Scale and other assessment tools. Sociodemographic and clinical factors were entered as predictors in logistic regression models, with early-onset depression (4 weeks) or persistent depression (24 weeks) as the outcomes.
Early-onset depression was predicted by preexisting depressive symptoms' severity (baseline HAM-D scores: OR=1.24; 95% CI: 1.03, 1.50; p=0.03) and by the presence of additional physical comorbidities (OR=3.74; 95% CI: 1.12, 12.5; p=0.03). Persistent depression was predicted by additional physical comorbidities (OR=7.75; 95% CI: 1.33, 45.0, p=0.02), depressive temperament (OR=8.95; 95% CI: 1.32, 60.6; p=0.03) and, at trend-level, by unknown mode of HCV contagion (OR=5.21; 95% CI: 0.89, 30.4; p=0.07).
The incidence of IFN-related depression is associated with factors related to patients' physical and temperamental characteristics. Further research should include comprehensive biopsychosocial assessments to improve the early detection and treatment of vulnerable patients in the real clinical world.
本研究旨在探讨不同生物心理社会风险因素在干扰素α（IFN）治疗的丙型肝炎（HCV）患者中抑郁发作的作用。
招募 HCV 患者并前瞻性评估其基线及 IFN 治疗开始后 4、8 和 24 周时的情况。评估包括汉密尔顿抑郁和焦虑量表（HAM-D 和 HAM-A）、多伦多述情障碍量表、孟菲斯、比萨、巴黎和圣地亚哥 110 项人格问卷（TEMPS-A）、Young 躁狂评定量表和其他评估工具。将人口统计学和临床因素作为预测因子输入逻辑回归模型，以早期（4 周）或持续（24 周）抑郁发作为结局。
早期抑郁发作由既往抑郁症状严重程度（基线 HAM-D 评分：OR=1.24；95%CI：1.03，1.50；p=0.03）和其他躯体共病的存在（OR=3.74；95%CI：1.12，12.5；p=0.03）预测。持续性抑郁发作由其他躯体共病（OR=7.75；95%CI：1.33，45.0，p=0.02）、抑郁气质（OR=8.95；95%CI：1.32，60.6；p=0.03）预测，且在趋势水平上，由未知 HCV 传染方式（OR=5.21；95%CI：0.89，30.4；p=0.07）预测。
IFN 相关抑郁的发生率与与患者身体和气质特征相关的因素有关。进一步的研究应包括全面的生物心理社会评估，以改善真实临床环境中易受影响患者的早期检测和治疗。
