De novo depression and anxiety disorders and influence on adherence during peginterferon-alpha-2a and ribavirin treatment in patients with hepatitis C
Article first published online: 6 NOV 2007
Alimentary Pharmacology & Therapeutics
Volume 27, Issue 3, pages 257–265, February 2008
How to Cite
MARTÍN-SANTOS, R., DÍEZ-QUEVEDO, C., CASTELLVÍ, P., NAVINÉS, R., MIQUEL, M., MASNOU, H., SOLER, A., ARDEVOL, M., GARCÍA, F., GALERAS, J. A., PLANAS, R. and SOLÀ, R. (2008), De novo depression and anxiety disorders and influence on adherence during peginterferon-alpha-2a and ribavirin treatment in patients with hepatitis C. Alimentary Pharmacology & Therapeutics, 27: 257–265. doi: 10.1111/j.1365-2036.2007.03568.x
- Issue published online: 6 NOV 2007
- Article first published online: 6 NOV 2007
- Publication data Submitted 1 June 2007 First decision 18 June 2007 Resubmitted 26 September 2007 Second decision 13 October 2007Resubmitted 30 October 2007 Accepted 1 November 2007
Background Depression and anxiety have been associated with interferon treatment and low treatment adherence.
Aim To study the incidence and associated risk factors of depressive and anxiety disorders during pegylated interferon plus ribavirin and treatment adherence in a prospective cohort of 176 patients with chronic hepatitis C patients.
Methods Patients were interviewed at baseline using the Structured Clinical Interview for DSM-IV Mental Disorders and the Patient Health Questionnaire and the Hospital Anxiety and Depression Scale were completed. Both questionnaires were completed also after 4, 12 and 24 weeks of treatment.
Results De novo depressive and/or anxiety disorders were diagnosed in 53 (36%) patients, in whom antidepressants and/or anxiolytics were administered. Higher baseline depression-subscale score (OR = 27.8, 95% CI = 2.82–333), primary education level (OR = 3.1, 95% CI = 1.40–7.03) and being an immigrant (OR = 3.2, 95% CI = 1.12–9.47) were predictors of psychiatric disorders during anti-viral therapy. The percentage of patients with good adherence was lower in those with depression and/or anxiety (79% vs. 90%, P < 0.04). Only one patient (1%) discontinued treatment because of a major depressive episode. Depression and/or anxiety disorders had no effect on attainment of sustained virological response.
Conclusion Early detection and treatment of depressive and anxiety disorders favours good adherence to anti-viral treatment in hepatitis C.