在干扰素治疗的抑郁症双相模式

StephenW

在干扰素治疗的抑郁症双相模式
Biphasic pattern of depression and its predictors during pegylated interferon-based therapy in chronic hepatitis B and C patients.
Huang YW, Hu JT, Hu FC, Chang CJ, Chang HY, Kao JH, Yang SS, Chen DS.
Source
Liver Center, Cathay General Hospital Medical Center, Taipei, Taiwan.
Abstract
BACKGROUND:
It remains unclear whether depression in chronic hepatitis B and chronic hepatitis C during pegylated interferon-based therapy is associated with the virus, drug, or ethnic background. We aimed to perform a prospective study to evaluate the clinical course of depression and its predictors in consecutive non-cirrhotic chronic hepatitis B and C patients of same ethnicity receiving pegylated interferon-based therapy.
METHODS:
The occurrence and severity of depression were actively assessed by the Hamilton Depression Rating Scale before therapy and at week 2, 4, 6, 8, 10, 12, and every 4 weeks during treatment until the end of therapy. Extensive amount of variables (repeated measurements, time variables, and interactions between all variables) were included in
Generalized Estimating Equations to analyze the predictors of depression.
RESULTS:
A total of 158 consecutive patients (73 chronic hepatitis B and 85 chronic hepatitis C patients) were enrolled. Depression (Hamilton Depression Rating Scale ? 11) occurred in a biphasic pattern, at treatment week 2 to 10 and week 16 to 36. Treatment week < 10 predicts more depression and treatment week > 12 predicts less depression, suggesting the predictability of time variable during treatment on depression. Furthermore, chronic hepatitis C or pre-existing depression is independent predictor of depression in these patients (p<0.001).
CONCLUSIONS:
Depression occurred in a biphasic pattern during pegylated interferon- based therapy and should be early and actively assessed especially in patients with chronic hepatitis C or pre-existing depression.

StephenW

聚乙二醇化干扰素为基础的治疗慢性乙型和丙型肝炎患者中双相抑郁症和它的预测模式。
黄YW，胡JT，胡FC，张智仁，张HY，高JH，杨SS，陈DS。

肝病中心，国泰综合医院医疗中心，台北，台湾。

背景：
目前还不清楚是否与聚乙二醇化干扰素为基础的治疗抑郁症的慢性乙型肝炎和慢性丙型肝炎病毒，药物或种族背景。我们的目的是进行前瞻性研究，以评估在连续的非肝硬化慢性乙型和丙型肝炎患者的同一种族的接受聚乙二醇化干扰素为基础的治疗抑郁症及预测因子的临床过程。
方法：
抑郁症的发生和严重程度都在积极评估汉密尔顿抑郁量表在治疗前和第2周，4，6，8，10，12，每4周治疗，直到治疗结束时。数量庞大的变量（重复测量，时间变量，所有变量之间的相互作用）被列入在广义估计方程分析抑郁症的预测。
结果：
总共有158例患者（73慢性乙型肝炎患者和85例慢性丙型肝炎患者）的患者。抑郁症（汉密尔顿抑郁量表11）发生在双相模式，在治疗一周一周2至10及16至36。治疗10周预测抑郁症，治疗12周预测少抑郁症，建议对抑郁症的治疗过程中的时间变量的可预测性。此外，慢性丙型肝炎或预先存在的抑郁症是抑郁症的独立预测因素，在这些患者（P <0.001）。
结论：
大萧条发生在双相模式在聚乙二醇化干扰素为基础的治疗，应及早积极的评估，尤其是在慢性丙型肝炎或预先存在的抑郁症患者。