Rifflet H, Vuillemin E, Oberti F, Duverger P, Lainé P, Garré J B, Calés P
Service d'Hépato-Gastroentérologie, CHU, Angers.
Gastroenterol Clin Biol. 1998 Mar;22(3):353-7.
We report 5 cases of psychiatric side effects in patients treated with alpha interferon for chronic viral C hepatitis. The first case includes depression with suicidal impulses without a suicide attempt; there was a positive rechallenge of interferon. In the second and third cases, depression occurred during interferon therapy, but has not disappeared after interferon withdrawal. In the 4th and 5th cases, depression occurred after interferon withdrawal. Overall, suicide was attempted in 4 cases after interferon withdrawal and was responsible for 2 deaths. The prevalence of suicide attempts during the 6 to 12 months of interferon therapy was 0% compared to 1.3% during the 6 months after interferon therapy (P < 0.05) in 306 patients with chronic hepatitis C treated by interferon in our local area network during the same period.
a) depression does not always disappear after interferon is discontinued; b) regular psychiatric follow-up is justified during treatment with interferon; c) psychiatric supervision should be continued, even more frequently after interferon withdrawal; d) the increased risk of psychiatric side-effect due to interferon as well as their severity suggest interferon should be administered with caution; e) the role of interferon can only be evaluated in controlled studies including the incidence and predictive value of emotional disorders.
我们报告了5例接受α干扰素治疗慢性丙型病毒性肝炎患者出现的精神副作用。第一例包括伴有自杀冲动但未自杀的抑郁症；再次使用干扰素时出现阳性反应。第二例和第三例中，抑郁症在干扰素治疗期间出现，但在停用干扰素后未消失。第四例和第五例中，抑郁症在停用干扰素后出现。总体而言，4例患者在停用干扰素后试图自杀，其中2例死亡。在我们局域网同期接受干扰素治疗的306例慢性丙型肝炎患者中，干扰素治疗6至12个月期间自杀未遂发生率为0%，而在干扰素治疗后6个月期间为1.3%（P<0.05）。
a）停用干扰素后抑郁症并非总是消失；b）干扰素治疗期间进行定期精神科随访是合理的；c）即使在停用干扰素后，精神科监测也应继续，且应更频繁进行；d）干扰素导致精神副作用的风险增加及其严重性表明应谨慎使用干扰素；e）干扰素的作用只能在包括情绪障碍发生率和预测价值的对照研究中进行评估。
