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

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Abstract

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. © 2008 The Authors.
Original languageEnglish
Pages (from-to)257-265
JournalAlimentary Pharmacology and Therapeutics
Volume27
Issue number3
DOIs
Publication statusPublished - 1 Feb 2008

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