Association of Changes in Mood Status and Psychosocial Well-Being with Depression During Interferon-Based Treatment for Hepatitis C

Jung-Seok Choi, Won Kim, Bo Kyung Sohn, Jun-Young Lee, Hee Yeon Jung, Sohee Oh, Sae Kyoung Joo, Hwi Young Kim, Yong Jin Jung, Jung-Seok Choi, Won Kim, Bo Kyung Sohn, Jun-Young Lee, Hee Yeon Jung, Sohee Oh, Sae Kyoung Joo, Hwi Young Kim, Yong Jin Jung

Abstract

Objective: The aims of this prospective study were to investigate temporal changes in mood status and distress level, as well as the development of depression, during pegylated interferon (PEG-IFN)-based treatment of patients with chronic hepatitis C (CHC). We also explored whether baseline demographic, psychiatric, and personality traits predicted the evolution of depression.

Methods: CHC patients without depression were screened with laboratory tests; psychiatric interviews; and evaluations of mood symptoms, level of distress, and personality traits. A total of 67 treatment-naïve patients with CHC were consecutively treated with PEG-IFN-α-2a plus ribavirin for 48 (genotype 1, n=29) or 24 (genotype 2, n=38) weeks. Patients were followed prospectively every 4 weeks during the treatment period.

Results: Seven patients (10.4%) were diagnosed with major depressive disorder (MDD), and eight (11.9%) developed subsyndromal depression. Times to onset of MDD and subsyndromal depression were 6.67±5.01 and 11.11±5.58 weeks, respectively, after initiation of treatment. Patients who developed MDD had significantly increased fatigue and anxiety and poor psychological well-being during the course of treatment. Pretreatment subthreshold mood symptoms were a significant predictor of depression.

Conclusion: An early psychiatric assessment may be helpful in improving psychological well-being in those with CHC, leading to adherence to PEG-IFN-based treatment.

Keywords: Depression; Distress; Hepatitis C; Interferon; Psychosocial well-being.

Figures

Figure 1. Time course of depressive mood…
Figure 1. Time course of depressive mood (A), anxiety (B), and level of distress (C) in all patients during interferon-based treatment. *p<0.05; horizontal bar represents standard error. BDI: Beck Depression Inventory, BAI: Beck Anxiety Inventory, PWI: Psychosocial Well-being Index.
Figure 2. Time course of scores in…
Figure 2. Time course of scores in Korean version of Profile of Mood States (K-POMS; A: tension-anxiety, B: depression-dejection, C: anger-hostility, D: vigor-activity, E: fatigue-inertia, F: confusion-bewilderment) in all patients during interferon-based treatment. *p<0.05; horizontal bar represents standard error.
Figure 3. Time course of depressive mood…
Figure 3. Time course of depressive mood (A), anxiety (B), and level of distress (C) in patients with major depressive disorder and those without depression during interferon-based treatment. As there was only one patient with depressive disorder and HCV genotype 1 who completed antiviral treatment for 48 weeks, this figure expressed data from baseline through 28 weeks. *p<0.05, **p<0.01, ***p<0.001; horizontal bar represents standard error. BDI: Beck Depression Inventory, BAI: Beck Anxiety Inventory, PWI: Psychosocial Well-being Index, HCV: hepatitis C virus.
Figure 4. Time course of scores in…
Figure 4. Time course of scores in Korean version of Profile of Mood States (K-POMS; A: tension-anxiety, B: depression-dejection, C: anger-hostility, D: vigor-activity, E: fatigue-inertia, F: confusion-bewilderment) in patients with major depressive disorder and those without depression during interferon-based treatment. As there was only one patient with depressive disorder and HCV genotype 1 who completed antiviral treatment for 48 weeks, this figure expressed data from baseline through 28 weeks. *p<0.05, **p<0.01, ***p<0.001; horizontal bar represents standard error. HCV: hepatitis C virus.

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