Depression induced by treatment with interferon-alpha in patients affected by hepatitis C virus

Background: Several studies found a high incidence rate of neuro-psychiatric complications during long-term therapy with interferon alpha (IFNα), e.g. slowness, severe fatigue, hypersomnia, lethargy, depressed mood, mnemonic troubles, irritability, short temper, emotional lability, social withdrawal, and lack of concentration. The aim of this study was to examine the incidence of depressed mood and major depression in patients who were treated with IFNα. Methods: 30 patients, affected by chronic active C-hepatitis, have been evaluated at baseline and 3 months after IFNα treatment. The evaluation consisted of psychometric assessments employing the DSM-IV criteria and the Montgomery Asberg Depression Rating Scale (MADRS). Results: At end-point, 40.7% of the patients suffered from a full blown major depression, according to the DSM-IV criteria for major depression. IFNα treatment induced a significant increase in the MADRS score from baseline to 3 months later. The MADRS items which were significantly increased at end-point were: expressed and unexpressed sadness; irritability; insomnia; loss of appetite; and asthenia. Discussion: The results show that prolonged IFNα treatment may induce depressive symptoms and major depression in a considerable number of subjects.