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Interferon-alpha-induced psychiatric side effects in patients with chronic viral hepatitis: a prospective, observational, controlled study

Published online by Cambridge University Press:  11 October 2011

M. Germana Orrù
Affiliation:
Clinica Psichiatrica, Università degli Studi di Cagliari, Cagliari, Italy
Antonella Baita
Affiliation:
Clinica Psichiatrica, Università degli Studi di Cagliari, Cagliari, Italy
Rossella Sitzia
Affiliation:
Clinica Psichiatrica, Università degli Studi di Cagliari, Cagliari, Italy
Alessandra Costa
Affiliation:
Clinica Psichiatrica, Università degli Studi di Cagliari, Cagliari, Italy
Elisabetta Muntoni
Affiliation:
Clinica Psichiatrica, Università degli Studi di Cagliari, Cagliari, Italy
Sabine Landau
Affiliation:
Istituto di Psichiatria, King's College, London, UK
Luchino Chessa
Affiliation:
Clinica Medica, Università degli Studi di Cagliari, Cagliari, Italy
M. Giulia Farci
Affiliation:
Clinica Medica, Università degli Studi di Cagliari, Cagliari, Italy
Bernardo Carpiniello
Affiliation:
Clinica Psichiatrica, Università degli Studi di Cagliari, Cagliari, Italy
Carmine M. Pariante*
Affiliation:
Istituto di Psichiatria, King's College, London, UK
*
Address for correspondence: Dr. C.M. Pariante, Section of Clinical Neuropharmacology, PO Box 51, Institute of Psychiatry, King's College London, 1 Windsor Walk, London SES 8AF(United Kingdom). Fax: +44-20-7848.0051 E-mail: c.pariante@iop.kcl.ac.uk

Summary

Aims — Patients with chronic viral hepatitis suffer from a high prevalence of psychiatric problems. Furthermore, the treatment for chronic viral hepatitis, with interferon (IFN) alpha, induces the occurrence of further psychopathological symptoms. The autors examined whether patients with a pre-existing psychiatric diagnosis had more severe IFN alpha-induced psychiatric adverse effects, and whether they were more likely to interrupt the IFN alpha therapy, compared with control patients with no pre-existing psychiatric diagnosis. They also examined the psychopharmacological management of the interferon-alpha-induced psychiatric side effects. Methods — The authors studied prospectively 60 patients with chronic hepatitis B or C in Cagliari, Italy. Patients underwent psychiatric assessment before starting interferon alpha and monthly throughout the therapy. Results — After adjusting for the baseline psychopathology, there was no statistically significant difference in interferon-alpha-induced psychiatric adverse effects between patients with a pre-existing psychiatric diagnosis and controls. There was also no evidence that psychiatric cases were more likely than controls to interrupt the IFN alpha therapy because of psychiatric side effects. Moreover, there was no difference in the psychiatric adverse effects severe enough to require psychopharmacological treatment. Finally, psychopharmaco-logical management successfully treated psychiatric symptoms induced by the IFN alpha. Conclusions — Patients with a pre-existing psychiatric diagnosis do not have a specific vulnerability to interferon-alpha-induced psychiatric adverse effects.

Declaration of Interest: none of the authors have conflict of interests in writing this paper; CM. Pariante is funded by the UK Medical Research Council and by the NARSAD and the Guy's and St Thomas Charity

Type
Original Papers
Copyright
Copyright © Cambridge University Press 2005

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