Biopsychosocial predictors of interferon-related depression in patients with Hepatitis C

Murri, Martino Belvederi; Cecere, Angela Chiara; Masotti, Mattia; Sammito, Giorgio; Marca, Alessandra La; Torres, Giuseppe Valerio; Bonfitto, Iris; Cuozzo, Edwige; Rossi, Luca; Serviddio, Gaetano; Villani, Rosanna; Picciotto, Antonino; Bellomo, Antonello; Amore, Mario

doi:10.1016/j.ajp.2017.01.001

Cited by 8 publications

(8 citation statements)

References 36 publications

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“…Gender has also been regarded as a significant vulnerability factor for depression (Kessler et al 1993;Schuch et al 2014), and a recent meta-analysis revealed female gender to be associated (weak effect) with depression emergence during IFN-α treatment (Udina et al A c c e p t e d M a n u s c r i p t developing depression during HCV treatment. In contrast to a recent study (Belvederi Murri et al 2017), our findings indicated that being on triple therapy was significantly associated with lower odds of developing MDD, but only for male patients. Evidence suggested higher SVR rates among patients on triple therapy compared with those on a standard regimen of pegylated interferon and ribavirin (e.g., Jacobson et al 2011).…”

Section: Mddcontrasting

confidence: 99%

A longitudinal study assessing depression in hepatitis C: Does gender play a role in the new-onset depression during interferon-alpha treatment?

et al. 2018

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In this prospective study conducted from October 2013 to June 2015 in Brighton, England, we examined differences between men and women in new-onset major depressive disorder (MDD) during interferon-alpha-based (IFN-α) therapy for hepatitis C virus (HCV). We included 155 HCV-infected patients (47 women), eligible to receive HCV therapy, including direct-acting antivirals. The Semi-Structured Clinical Interview was used to assess MDD. Severity of depressive symptoms was assessed using the Hamilton Depression Rating Scale. Patients were assessed at baseline, during treatment and 6 months after treatment completion. A significant increase in depressive symptoms was observed in the total sample from baseline to week 4, and a significant decrease was observed from end of treatment (week 24) to the sustained virological response (SVR) end point at 6 months posttreatment. Women were more likely to have a MDD at week 24. In both men and women, neurovegetative and mood-cognitive syndromes increased significantly at the early stage of treatment but remitted by the end of HCV therapy. Proportions with SVR were similar among females and males (91.5 percent vs. 87 percent). Under an inflammatory condition, boosted by interferon-based treatments, these results suggest that female gender is not associated with increased vulnerability for developing depression during IFN-α therapy.

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Section: Mddcontrasting

confidence: 99%

A longitudinal study assessing depression in hepatitis C: Does gender play a role in the new-onset depression during interferon-alpha treatment?

et al. 2018

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“…Specifically, the authors showed that alexithymia particularly altered the mental component of health-related quality of life (β = −0.54; t = −2.63; p = 0.01). Finally, Murri et al ( 2017 ) did not detect a significant role of alexithymia in predicting persistent IFN-related depression but the subsample of 12 HCV patients developing persistent depression reported higher TAS-20 scores (56.7 ± 15.9) than 43 patients without depression (48.7 ± 14.8), although not at a statistically significant level ( t = 1.62, p = 0.11).…”

Section: Resultsmentioning

confidence: 90%

“…Differently from previous studies on FGID and IBD, 8 of the 10 included studies evaluating alexithymia in hepatology had a follow-up study design (Fukunishi et al, 2002 , 2003 ; Nardelli et al, 2013 ; Palmieri et al, 2013 ; Porcelli et al, 2014a , 2015 ; Cozzolongo et al, 2015 ; Murri et al, 2017 ). Research investigations focused more on the role that alexithymia might play in the course of disease and medical treatment rather that its prevalence.…”

Section: Resultsmentioning

confidence: 99%

“…In line with the view of alexithymia as a personality dimension associated with affective dysregulation, several studies have found consistently that alexithymic traits negatively influence a series of clinical outcomes, that are strictly related to the subjective perception of health. Specifically, the following were the main results in this regard: (1) in patients with FGID (Arun, 1998 ; Jones et al, 2004 , 2006 ) and also in those with non-alcoholic liver disease (Blomhoff and Malt, 1995 ) higher scores of alexithymia were directly associated with higher levels of negative emotional traits such as neuroticism, rigidity, introversion, and perfectionism; (2) there was a significant relationship between alexithymia and depressive symptoms in patients with FGID and peptic ulcer (Faramarzi et al, 2014 ), as well as in those with HCV and cirrhosis (Rustgi et al, 2010 ; Nardelli et al, 2013 ; Murri et al, 2017 ); (3) alexithymia correlated significantly with insecure attachment relations in patients with IBD (Bengtsson et al, 2013 ) and gastroesophageal reflux disorder (Farinelli et al, 2007 ); (4) alexithymia was significantly associated with lower quality of life and impaired psychosocial functioning in patients with HCV (Cozzolongo et al, 2015 ) and liver carcinoma (Palmieri et al, 2013 ), IBD (Verissimo et al, 1998 ; Iglesias-Rey et al, 2012 ; La Barbera et al, 2017 ), and FGID as well (Portincasa et al, 2003 ; Van Oudenhove et al, 2011b ; Jones et al, 2013 ).…”

Section: Discussionmentioning

confidence: 99%

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Alexithymia in Gastroenterology and Hepatology: A Systematic Review

Carrozzino

Porcelli

2018

Front. Psychol.

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Background: Alexithymia is a multifaceted personality construct that represents a deficit in the cognitive processing of emotions and is currently understood to be related to a variety of medical and psychiatric conditions. The present review aims to investigate the relationship of alexithymia with gastrointestinal (GI) disorders as functional gastrointestinal disorders (FGID, as irritable bowel syndrome (IBS) and functional dyspepsia) and inflammatory bowel disease (IBD) [ulcerative colitis (UC) and Crohn's disease (CD)] and liver diseases as chronic hepatitis C (CHC), cirrhosis, and liver transplantation.Methods: The articles were selected from the main electronic databases (PsycInfo, Medline, PubMed, Web of Science, Scopus, Cochrane, and ScienceDirect) using multiple combinations of relevant search terms (defined GI and liver diseases, articles in English, use of the Toronto scales [TAS] for alexithymia). The TAS was selected as inclusion criterion because it is the most widely used measure, thus allowing comparisons across studies.Results: Forty-eight studies met the inclusion criteria, of which 38 focused on GI disorders (27 on FGID and 11 on IBD) and 10 on liver diseases. Most studies (n = 30, 62%) were cross-sectional. The prevalence of alexithymia was higher in FGID (two third or more) than IBD and liver diseases (from one third to 50% of patients, consistent with other chronic non-GI diseases) than general population (10–15%). In functional disorders, alexithymia may be viewed as a primary driver for higher visceral perception, symptom reporting, health care use, symptom persistence, and negative treatment outcomes. Also, it has been found associated with psychological distress and specific GI-related forms of anxiety in predicting symptom severity as well as post-treatment outcomes and is associated with several psychological factors increasing the burden of disease and impairing levels of quality of life. A number of critical issues (small sample sizes, patients referred to secondary and tertiary care centers, cross-sectional study design, use of one single scale for alexithymia) constitutes a limitation to the generalization of findings.Conclusions: Alexithymia showed to play different roles in gastroenterology according to the clinical characteristics and the psychological burden of the various disorders, with main relevance in increasing subjective symptom perception and affecting negatively post-treatment outcomes.

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“…And in view that there might be difference of anxiety and depression in mRCC patients treated by IFN-α, exploring the predicting factors for the incidences of anxiety and depression might provide guidance for the patient selection in clinical practice. To our best knowledge, this is the first study to investigate predictive factors for the incidence of depression and anxiety in mRCC patients treated by IFN-α, and the majority of prior studies only focus on patients with hepatitis and other solid tumors (29)(30)(31). A prospective cohort study illustrates that severity of preexisting depressive symptoms and additional physical comorbidities predict early onset of depression, and additional physical comorbidities as well as depressive temperament associate with persistent depression in (32).…”

Section: Discussionmentioning

confidence: 97%

Evaluation and predictive factors analyses for patient-self-reported depression, anxiety and quality of life in patients with metastatic renal cell carcinoma underwent interferon-α treatment: a prospective cohort study

Wang¹,

Song²,

Zhang³

et al. 2018

Transl. Cancer Res

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Background: This study aimed to investigate the patient-self-reported depression, anxiety and quality of life (QoL) as well as their predictive factors in patients with metastatic renal cell carcinoma (mRCC) underwent interferon-alpha (IFN-α) treatment.Methods: A total of 127 patients with mRCC underwent IFN-α treatment were consecutively enrolled in this prospective cohort study. Anxiety, depression and QoL were assessed at week 0 (W0), W4, W8 and W12 by Hospital Anxiety and Depression Scale (HADS) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30 Scale), respectively.Results: The percentages of anxiety and depression both increased at W12 compared with W0. The EORTC QLQ-C30 Scale-Global health status score, EORTC QLQ-C30 Scale-Function and EORTC QLQ-C30 Scale-Symptoms scores did not deteriorate at W4, W8 or W12 compared with W0. Multivariate logistic regression analyses revealed that older age and elevated level of highest education independently predict reduced risk of HADS-Anxiety score elevation at W12, while hypertension was an independent predictive factor for increased risk. Older age also independently associated with less risk of elevated HADS-Depression score. Smoke, hypertension, diabetes and higher ECOG performance were independent predicting factors for escalated risk of EORTC QLQ-C30 Scale-Global health status score elevation at W12, and higher ECOG performance was an independent predicting factor for increased risk of elevated EORTC QLQ-C30 Scale-Function score at W12. Conclusions:In conclusion, anxiety and depression increased while QoL did not deteriorate in mRCC patients during IFN-α treatment, and age, highest education, hypertension, smoke, diabetes as well as higher ECOG performance status correlated with their aggravation.

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Biopsychosocial predictors of interferon-related depression in patients with Hepatitis C

Cited by 8 publications

References 36 publications

A longitudinal study assessing depression in hepatitis C: Does gender play a role in the new-onset depression during interferon-alpha treatment?

A longitudinal study assessing depression in hepatitis C: Does gender play a role in the new-onset depression during interferon-alpha treatment?

Alexithymia in Gastroenterology and Hepatology: A Systematic Review

Evaluation and predictive factors analyses for patient-self-reported depression, anxiety and quality of life in patients with metastatic renal cell carcinoma underwent interferon-α treatment: a prospective cohort study

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