De Novo Depression and Anxiety Disorders and Influence on Adherence
During Peginterferon-Alpha-2a and Ribavirin Treatment in Patients With
Hepatitis C
R. Martín-Santos; C. Díez-Quevedo; P. Castellví; R. Navinés; M. Miquel;
H. Masnou; A. Soler; M. Ardevol; F. García; J. A. Galeras; R. Planas;
R. Solà
Summary
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.
http://www.medscape.com/viewarticle/568564?src=mp
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