Gut Liver. 2017;11(3):426-433.

Prevalence and Incidence of Depression during Interferon-Based Antiviral Therapy in Chronic Hepatitis C Patients in the Republic of Korea.

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제1저자 백주영 · 교신저자 정숙향

PMID 28335101 PMC5417786 DOI 10.5009/gnl16242 IF 4.1 소화기내과

소속 (4)

Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Department of Internal Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea.
Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea.
Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea.

Abstract

BACKGROUND/AIMS The association between depression and chronic hepatitis C virus (HCV) infection or pegylated interferon α and ribavirin therapy (PR therapy) has not been extensively studied in Korea. We aimed to clarify the prevalence of depression and its incidence during PR therapy in chronic hepatitis C (CHC) patients.

METHODS In this prospective, multicenter study, 114 CHC patients were screened for depression using two self-reported scales, the Beck Depression Inventory-I (BDI-I) and the Hospital Anxiety and Depression scale (HADS). The incidence of depression during PR therapy was evaluated in 62 patients who underwent PR therapy during the study period.

RESULTS The prevalence of baseline depression was 17.5% according to the BDI-I score ≥10 criterion and 4.4% according to the HADS-D score ≥8 criterion in the 114 CHC patients, and it was significantly associated with an unmarried state. During PR therapy, depression developed in 34.6% according to the BDI-I scale and 29.5% according to the HADS-D, which negatively affected sustained virologic response (SVR).

CONCLUSIONS The prevalence of depression in Korean CHC patients appears to be low compared to that in Western patients; however, its incidence during PR therapy (approximately 30%) was similar to that of other populations, which led to a lower SVR rate. Active screening and multidisciplinary management of depression during PR therapy is warranted.

Keywords

Beck Depression Inventory-IDepressionHepacivirusHospital Anxiety and Depression scaleInterferons

Figures

**Fig. 1** Development of depression during antiviral treatment. Depressive symptoms developed in 34.6% (n=18) with a BDI-I score ≥10 (A) and 29.5% (n=18) with a HADS-D score ≥8 (B) among 52 and 61 patients who had no depression at baseline, respectively. The point prevalence of moderate to severe depression (BDI-I score ≥16 and HADS-D ≥11) was 17.3% (n=9) according to the BDI-I score and 9.8% (n=6) according to the HADS-D score over the course of pegylated interferon and RBV therapy. The majority of patients exhibited increased BDI-I or HADS-D scores during treatment, which returned to normal after the completion of treatment. BDI-I, Beck Depression Inventory-I; HADS-D, Hospital Anxiety and Depression scale-Depression.

**Fig. 2** Cumulative incidence of depression during antiviral treatment with pegylated interferon α and ribavirin. The cumulative incidence rates of depression during antiviral therapy were 21.5% versus 21.5% at 12 weeks, 30.4% versus 27.2% at 24 weeks, 38.3% versus 34.2% at 36 weeks according to BDI-I (A) versus HADS-D (B), respectively. BDI-I, Beck Depression Inventory-I; HADS-D, Hospital Anxiety and Depression scale-Depression; FU, follow-up; Pt., patients.

**Fig. 3** Changes in the Beck Depression Inventory-I (BDI-I) score during pegylated interferon and ribavirin therapy among patients with underlying depression at baseline. Seven patients with pretreatment depression showed aggravation of the BDI-I score during antiviral therapy, and two patients (number 2 and number 10) received antidepressant therapy. Moreover, one patient did not recover after 6 months from the end of pegylated interferon α and ribavirin therapy.

그림 출처: PubMed Central 공개 논문 (PMC5417786)

Conflict of interest statement

CONFLICTS OF INTEREST. No potential conflict of interest relevant to this article was reported.

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