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一项评估丙型肝炎患者抑郁症的纵向研究:性别在α干扰素治疗期间新发抑郁症中起作用吗?

A longitudinal study assessing depression in hepatitis C: Does gender play a role in the new-onset depression during interferon-alpha treatment?

作者信息

Fialho Renata, Pereira Marco, Gilleece Yvonne, Rusted Jennifer, Whale Richard

机构信息

a School of Psychology , University of Sussex , Brighton , United Kingdom.

b Sussex Partnership NHS Foundation Trust , Brighton , United Kingdom.

出版信息

Women Health. 2019 Feb;59(2):181-195. doi: 10.1080/03630242.2018.1449778. Epub 2018 Jul 24.

Abstract

In this prospective study conducted from October 2013 to June 2015 in Brighton, England, we examined differences between men and women in new-onset major depressive disorder (MDD) during interferon-alpha-based (IFN-α) therapy for hepatitis C virus (HCV). We included 155 HCV-infected patients (47 women), eligible to receive HCV therapy, including direct-acting antivirals. The Semi-Structured Clinical Interview was used to assess MDD. Severity of depressive symptoms was assessed using the Hamilton Depression Rating Scale. Patients were assessed at baseline, during treatment and 6 months after treatment completion. A significant increase in depressive symptoms was observed in the total sample from baseline to week 4, and a significant decrease was observed from end of treatment (week 24) to the sustained virological response (SVR) end point at 6 months posttreatment. Women were more likely to have a MDD at week 24. In both men and women, neurovegetative and mood-cognitive syndromes increased significantly at the early stage of treatment but remitted by the end of HCV therapy. Proportions with SVR were similar among females and males (91.5 percent vs. 87 percent). Under an inflammatory condition, boosted by interferon-based treatments, these results suggest that female gender is not associated with increased vulnerability for developing depression during IFN-α therapy.

摘要

在2013年10月至2015年6月于英国布莱顿开展的这项前瞻性研究中,我们调查了丙型肝炎病毒(HCV)患者在基于α干扰素(IFN-α)治疗期间新发重度抑郁症(MDD)的男女差异。我们纳入了155例符合接受HCV治疗(包括直接抗病毒药物)条件的HCV感染患者(47名女性)。采用半结构化临床访谈评估MDD。使用汉密尔顿抑郁评定量表评估抑郁症状的严重程度。在基线、治疗期间及治疗结束后6个月对患者进行评估。从基线到第4周,总样本中抑郁症状显著增加,从治疗结束时(第24周)到治疗后6个月的持续病毒学应答(SVR)终点,抑郁症状显著减少。女性在第24周时更易患MDD。在男性和女性中,神经植物性和情绪认知综合征在治疗早期均显著增加,但在HCV治疗结束时缓解。女性和男性的SVR比例相似(分别为91.5%和87%)。在炎症状态下,基于干扰素的治疗会加剧这种情况,这些结果表明,女性性别与IFN-α治疗期间患抑郁症的易感性增加无关。

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