Neuropsychiatric Complications of Interferons: Classification, Neurochemical Bases, and Management

Malek-Ahmadi, Parviz; Hilsabeck, Robin C.

doi:10.1080/10401230701333038

Cited by 24 publications

(19 citation statements)

References 90 publications

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“…Symptoms similar to but not meeting the criteria of full delirium have long been recognized in people treated with recombinant IFN [88] and occurrence of sub-syndromal delirium has been associated with adverse outcomes in elderly individuals [27]. In healthy human subjects experimental treatment with bacterial endotoxin produces a dose-dependent effect in cognitive function, emotional state and sleep [96,110].…”

Section: Reactions Of Cns Mediated By Molecules From Systemic Circulamentioning

confidence: 99%

The neuroinflammatory hypothesis of delirium

et al. 2010

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Delirium is a neuropsychiatric syndrome characterized by a sudden and global impairment in consciousness, attention and cognition. It is particularly frequent in elderly subjects with medical or surgical conditions and is associated with short-and long-term adverse outcomes. The pathophysiology of delirium remains poorly understood as it involves complex multi-factorial dynamic interactions between a diversity of risk factors. Several conditions associated with delirium are characterized by activation of the inflammatory cascade with acute release of inflammatory mediators into the bloodstream. There is compelling evidence that acute peripheral inflammatory stimulation induces activation of brain parenchymal cells, expression of proinflammatory cytokines and inflammatory mediators in the central nervous system. These neuroinflammatory changes induce neuronal and synaptic dysfunction and subsequent neurobehavioural and cognitive symptoms. Furthermore, ageing and neurodegenerative disorders exaggerate microglial responses following stimulation by systemic immune stimuli such as peripheral inflammation and/or infection. In this review we explore the neuroinflammatory hypothesis of delirium based on recent evidence derived from animal and human studies.

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Section: Reactions Of Cns Mediated By Molecules From Systemic Circulamentioning

confidence: 99%

The neuroinflammatory hypothesis of delirium

et al. 2010

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“…Review of literature has shown that persons with disabilities are more likely than others to experience mental health problems due to the psychological burden associated with the condition and/or the effects of the medications that are being used to suppress the disabling condition [24,28]. Also, mental disorders may share common risk factors with other health conditions and disabilities.…”

Section: Resultsmentioning

confidence: 99%

Disability as a Precursor to Mental Health Challenges

Salako¹

2017

Health Care Current Reviews

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Introduction: Disability is a controversial topic of discourse in recent times as a result of documented tremendous increase in the incidence rates of conditions that leave individuals with significant limitations or restrictions in functioning.Research has shown that health needs of persons with disabilities may vary depending on the nature of their disability which if left unattended to may lead to conditions that compound the effects of the disability such as mental health problems.Objective: The primary aim of this study is to narrative review of qualitative studies on the incidence of mental health problems amongst the disabled category.Methods: Keyword searches of Pubmed database, manual searches of reference lists of related articles.Results: Data gathered revealed that persons with disabilities are more likely than others to experience mental health problems which may be as a result of the psychological burden associated with the condition and/or the effects of the medications that are been used to suppress the disabling condition. Conclusion:Quality of life measures should be carried out on every individual in the disabled category. Mental health service should be provided early enough and focus on identified specific health needs of each individual involved so as to cushion the effects of disability, improve mental health outcomes and ultimately, the quality of life experienced by persons with disabilities.

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“…It was found that having been exposed to mood disorders in the past and carrying G allele variation of 5-hydroxytryptamine receptor 1-A (HTR1-A) significantly influenced the increase in IFN-induced depression [27]. Besides, reduced glucocorticoid negative feedback sensitivity leading to flattening of the diurnal cortisol slope [28], direct effect on central serotonin neurotransmission [29][30][31][32], activation of indoleamine 2,3-dioxygenase which indirectly converts tryptophan to kynurenine [33], and a decrease in the levels of brain-derived neurotrophic factor after IFN treatment might have played a role in the etiology of IFN-induced depression [34]. These associations are outside the scope of this study.…”

Section: Discussionmentioning

confidence: 99%

Depression and anxiety disorders during pegylated interferon treatment in patients with chronic hepatitis B

Sertöz

Tunçel

Taşbakan

et al. 2017

Psychiatry and Clinical Psychopharmacology

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Objectives: Interferon (IFN) treatment has many neuropsychiatric side effects such as depression and anxiety disorder. Although untreated depression is a major contributor to dosage reduction or premature discontinuation of the IFN treatment, it is found that depressive symptoms among patients undergoing hepatitis C virus (HCV) treatment are commonly overlooked during routine clinical interviews. Besides depression, anxiety disorders are shown to affect adherence to pegylated IFN (Peg-IFN) treatment in patients with hepatitis C. Despite the occurrence of neuropsychiatric side effects of IFN treatment being widely reported in patients with hepatitis C, there are few studies studying patients infected with hepatitis B virus (HBV). The aim of this prospective study was to evaluate the incidence and risk factors of depressive and anxiety disorders that occur during Peg-IFN treatment of patients with HBV. Methods: The sample consisted of volunteer patients who were diagnosed with HBV infection and who were decided to receive IFN treatment. During the study period, all consecutive patients with HBV infection and who would have IFN treatment were informed about the study and invited to participate. Thirty-seven chronic hepatitis B (CHB) patients were recruited for the study, but four of them were excluded due to psychiatric diagnosis at the initiation of the treatment. Therefore, the sample consisted of 33 patients with CHB, meeting the inclusion criteria. The participants had psychiatric assessment before the treatment and at 1st, 3rd, 6th, and 12th months. At each visit, the subjects were assessed with Clinical Global Impressions Scale, Hamilton Rating Scale for Depression (HRSD), and Hamilton Anxiety Rating Scale (HAM-A). Results: Among the 33 patients with HBV, 22 (66.7%) were men. Mean age was 35.97 ± 10.73 years. While follow-up, 6 patients dropped out from the study. Also, 13 patients were excluded from the study as they developed depression and/or anxiety disorder. Mean baseline HRSD and HAM-A scores were smaller than the following visits' scores. The difference was not statistically significant only for the 12th month assessments. Totally 14 (42.4%) patients developed depression/anxiety disorder during 1 year follow-up. Six (42.86%) of them received the diagnosis at the 1st month, 3 (21.43%) at the 3rd, 4 (28.57%), at 6th months, and 1 (7.14%) at the 12th month. When we compared the patients who developed depression/anxiety disorder with the patients who did not develop any psychiatric disorder, we found that the mean baseline HRSD score (t = 2.303, p = .028) and female percentage (p = .017) were statistically significantly higher in the depression/anxiety disorder group. Conclusions: There is an incidence of 42.4% for depression and/or anxiety disorders during Peg-IFN treatment. Females and patients with subsyndromal depressive symptoms should be referred to a psychiatrist and closely monitored especially for the first three months of the IFN treatment. ARTICLE HISTORY

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Neuropsychiatric Complications of Interferons: Classification, Neurochemical Bases, and Management

Cited by 24 publications

References 90 publications

The neuroinflammatory hypothesis of delirium

The neuroinflammatory hypothesis of delirium

Disability as a Precursor to Mental Health Challenges

Depression and anxiety disorders during pegylated interferon treatment in patients with chronic hepatitis B

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