RESUMEN
Population studies indicate women have higher prevalences of depression and anxiety than men. Interferon (IFN) is a biologic agent that can induce or exacerbate depression and/or anxiety. Whether women are more likely to experience these side effects of IFN during treatment remains to be determined. The aim of this study was to document levels of depression and anxiety in female and male patients before and during IFN-based treatment. This was a prospective open-label study in which depression was measured by Beck Depression Inventory (BDI) and anxiety by Hospital Anxiety and Depression Scale (HADS). Before treatment, the prevalence of depression was higher in females (3/13 [23%]) than males (1/25 [4%]), but the difference did not reach statistical significance (P = 0.12). Initial BDI scores were also higher in females but not significantly (P = 0.07). During treatment, BDI scores increased to a similar extent in both genders. A similar percentage of nondepressed patients at baseline developed depression (females: 50% versus males: 35%, P = 0.45). Before treatment, anxiety was significantly more common in females (7/13 [54%]) than males (3/25 [12%]) (P = 0.016) and median HADS scores were higher in females (P = 0.03). During treatment, increases in HADS scores were similar in the 2 genders. A similar percentage of patients without anxiety at baseline developed anxiety on treatment (females: 50% versus males: 23%, P = 0.31). The frequency and extent of IFN-induced/exacerbated depression and anxiety are not gender dependent.
Asunto(s)
Antivirales/efectos adversos , Antivirales/uso terapéutico , Ansiedad/inducido químicamente , Depresión/inducido químicamente , Hepatitis C Crónica/tratamiento farmacológico , Interferón-alfa/efectos adversos , Interferón-alfa/uso terapéutico , Ribavirina/uso terapéutico , Caracteres Sexuales , Adulto , Ansiedad/diagnóstico , Depresión/diagnóstico , Femenino , Hepacivirus/efectos de los fármacos , Hepatitis C Crónica/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Escalas de Valoración Psiquiátrica , Encuestas y CuestionariosRESUMEN
BACKGROUND: Hepatitis C virus (HCV) infection is associated with clinical depression,a condition that is aggravated on interferon-based therapy. In HCV infection, men often appear more resilient to depression than women. However, men are subject to depression in diseases that tend to be comorbid in HCV-infected. AIM: This study examined whether HCV-infected men with baseline comorbidities were more or less susceptible to depression prior to and on treatment. METHODS: Patients with chronic HCV infection preparing to begin treatment participated (n = 37). The presence of baseline comorbidities was determined by pretreatment medication regimes. Depression was measured by the Beck Depression Inventory prior to and following 2, 4, 8, and 12 weeks of interferon therapy. RESULTS: At baseline, cohorts with (n = 16) and without (n = 21) comorbidities had equivocal demographics and infection characteristics. Comorbidities did not associate with baseline depression. However, on treatment, men with baseline comorbidities demonstrated an elevated risk for the onset of de novo depression (odds ratio = 19.25; confidence interval = 1.41, 582.14; p = .008). This was not observed for women. Baseline comorbidities did not alter the need for treatment discontinuations or the ability to achieve a sustained viral response. CONCLUSION: The results of this study suggest that baseline comorbidities render men more susceptible to interferon treatment-induced depression.