Psychomotor retardation and vulnerability to interferon alpha induced major depressive disorder: Prospective study of a chronic hepatitis C cohort

Whale, Richard; Fialho, Renata; Rolt, Michael; Eccles, Jessica; Pereira, Marco; Keller, Majella; File, Alexandra; Haq, Inam; Tibble, Jeremy

doi:10.1016/j.jpsychores.2015.06.003

Cited by 11 publications

(16 citation statements)

References 41 publications

(56 reference statements)

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“…Our main findings are consistent with previous reports that have identified a significant prevalence of MDD during HCV treatment (Udina et al, 2012(Udina et al, , 2016Whale et al, 2015). The percentage found in this study is similar to the overall rate of new-onset depression (35%) reported by Alavi et al (2012).…”

Section: Discussionsupporting

confidence: 93%

“…In this context, and considering this biphasic model of depression, it was found that neurovegetative symptoms tend to develop early and depressive-cognitive symptoms tend to occur later (Capuron et al, 2002a). Regarding the specific symptoms of the neurovegetative syndrome, psychomotor slowing was shown to be a consistent predictor of later emergence of depression (Capuron et al, 2001;Raison et al, 2005;Whale et al, 2015). Recently, in a sample of HCV mono-infected patients, Loftis et al (2013) found that neurovegetative symptoms increased at an early stage of interferon treatment (week 2), though no significant changes in the cognitive-affective factor were observed.…”

Section: Introductionmentioning

confidence: 93%

“…Among coinfected patients, depression, irritability, sleep disorders and weight loss were reported as the most common neuropsychiatric adverse events during IFN-α treatment (Sulkowski, 2008). Data on neuropsychiatric effects of triple therapy are currently limited, but the prevalence of interferoninduced depression remains a significant issue (Alavi et al, 2012;Fialho et al, 2014;Whale et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

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Co-infection with HIV associated with reduced vulnerability to symptoms of depression during antiviral treatment for hepatitis C

Fialho

Pereira

Harrison

et al. 2017

Psychiatry Research

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In this prospective study, we examined new-onset major depressive disorder (MDD) and the differential expression of depressive symptoms in a sample of 132 HCV mono-infected and 40 HIV/HCV co-infected patients initiating pegylated interferon-based treatment, including protease inhibitor therapy. The semi-structured clinical interview (SCID-I) was used to assess MDD. Severity of depressive symptoms was assessed using the Hamilton Depression Rating Scale. Of the total sample, 60 patients (34.9%) developed SCID-I defined MDD during antiviral treatment. The proportion of HCV mono- and HIV/HCV patients developing MDD during treatment was not significantly different (37.9% vs. 25%; p=0.185). In both groups, there was a significant increase in HAMD total score from baseline to week 4, and a significant decrease between week 24 and 6 months post-treatment cessation. The greatest increase was observed in the symptoms of the neurovegetative syndrome. HCV mono-infected patients reported higher scores than co-infected patients, particularly impaired activity and somatic symptoms, but the differences were only significant at week 12. The finding that co-infected patients appear less vulnerable to the development of depressive symptoms during HCV treatment than HCV mono-infected patients warrants further exploration, including a thorough analysis of the biological and psychosocial factors associated with this emergence.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

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Co-infection with HIV associated with reduced vulnerability to symptoms of depression during antiviral treatment for hepatitis C

Fialho

Pereira

Harrison

et al. 2017

Psychiatry Research

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“…Eccles et al have demonstrated that hypothalamic-pituitary-adrenal axis hyperactivity prior to interferon based therapy evaluated through measurement of the waking salivary cortisol response was associated to depression during treatment [ 43 ]. Whale et al showed recently that younger age, previous history of major depression disorder, higher baseline psychomotor retardation and somatic symptoms item scores using the Hamilton Depression Rating Scale and HCV genotype 2 were implicated in depression during IFN treatment [ 44 ]. In the present study we excluded patients with major depression diagnosis at baseline and we could not find predictive factors for depression during IFN treatment, maybe due to small sample evaluated.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis C virus eradication improves immediate and delayed episodic memory in patients treated with interferon and ribavirin

et al. 2017

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BackgroundChronic hepatitis C virus (HCV) infection is associated with impairment of cognitive function and mood disorders. Our aim was to evaluate the impact of sustained virological response (SVR) on cognitive function and mood disorders.MethodA prospective exploratory one arm study was conducted. Adult clinically compensated HVC patients were consecutively recruited before treatment with interferon and ribavirin for 24 to 48 weeks, according to HCV genotype. Clinical, neurocognitive and mood assessments using the PRIME-MD and BDI instruments were performed at baseline, right after half of the expected treatment has been reached and 6 months after the end of antiviral treatment. Exclusion criteria were the use of illicit psychotropic substances, mental confusion, hepatic encephalopathy, hepatocellular carcinoma, severe anemia, untreated hypothyroidism, Addison syndrome and major depression before treatment.ResultsThirty six patients were enrolled and 21 completed HCV treatment (n = 16 with SVR and n = 5 without). Regardless of the viral clearance at the end of treatment, there was a significant improvement in the immediate verbal episodic memory (p = 0.010), delayed verbal episodic memory (p = 0.007), selective attention (p < 0.001) and phonemic fluency (p = 0.043). Patients with SVR displayed significant improvement in immediate (p = 0.045) and delayed verbal episodic memory (p = 0.040) compared to baseline. The baseline frequency of depression was 9.5%, which rose to 52.4% during treatment, and returned to 9.5% 6 months after the end of treatment, without significant difference between patients with and without SVR. Depressive symptoms were observed in 19.1% before treatment, 62% during (p = 0.016) and 28.6% 6 months after the end of treatment (p = 0.719).ConclusionsEradication of HCV infection improved cognitive performance but did not affect the frequency of depressive symptoms at least in the short range.

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“…Decreased psychomotor speed following IFN-alpha was in turn correlated with symptoms of depression and fatigue assessed by the Montgomery-Asberg Depression Rating Scale (MADRS; (Montgomery and Asberg, 1979) and the Multidimensional Fatigue Inventory (MFI)(Smets et al, 1995), respectively. Interestingly, psychomotor retardation was recently found to predict the development of depression during IFN-alpha therapy (Whale et al, 2015). Laboratory animals also exhibit decreased locomotor activity after exposure to inflammatory cytokines or inflammatory stimuli (e.g.…”

Section: Introductionmentioning

confidence: 99%

Inflammatory markers are associated with decreased psychomotor speed in patients with major depressive disorder

Goldsmith

Haroon

Woolwine

et al. 2016

Brain, Behavior, and Immunity

113

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Previous data have demonstrated that administration of inflammatory cytokines or their inducers leads to altered basal ganglia function associated with reduced psychomotor speed. Decreased psychomotor speed, referred to clinically as psychomotor retardation, is a cardinal symptom of major depressive disorder (MDD) and has been associated with poor antidepressant treatment response. We therefore examined the association between plasma inflammatory markers and psychomotor speed in ninety-three un-medicated patients with MDD. Psychomotor speed was assessed by a range of neuropsychological tests from purely motor tasks (e.g. movement latency and finger tapping) to those that involved motor activity with increasing cognitive demand and cortical participation (e.g. Trails A and Digit Symbol Substitution Task (DSST)). Linear regression analyses were performed to determine the relationship of inflammatory markers and psychomotor task performance controlling for age, race, sex, education, body mass index, and severity of depression. MDD patients exhibited decreased psychomotor speed on all tasks relative to normative standards. Increased IL-6 was associated with decreased performance on simple and choice movement time tasks, whereas MCP-1 was associated with decreased performance on the finger tapping task and DSST. IL-10 was associated with increased performance on the DSST. In an exploratory principle component analysis including all psychomotor tasks, IL-6 was associated with the psychomotor speed factor. Taken together, the data indicate that a peripheral inflammatory profile including increased IL-6 and MCP-1 is consistently associated with psychomotor speed in MDD. These data are consistent with data demonstrating that inflammation can affect basal ganglia function, and indicate that psychomotor speed may be a viable outcome variable for anti-inflammatory therapies in depression and other neuropsychiatric disorders with increased inflammation.

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Psychomotor retardation and vulnerability to interferon alpha induced major depressive disorder: Prospective study of a chronic hepatitis C cohort

Cited by 11 publications

References 41 publications

Co-infection with HIV associated with reduced vulnerability to symptoms of depression during antiviral treatment for hepatitis C

Co-infection with HIV associated with reduced vulnerability to symptoms of depression during antiviral treatment for hepatitis C

Hepatitis C virus eradication improves immediate and delayed episodic memory in patients treated with interferon and ribavirin

Inflammatory markers are associated with decreased psychomotor speed in patients with major depressive disorder

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