Sadness and mild cognitive impairment as predictors for interferon-alpha-induced depression in patients with hepatitis C

Br J Psychiatry. 2015 Jan;206(1):45-51. doi: 10.1192/bjp.bp.113.141770. Epub 2014 Oct 30.


Background: Antiviral therapy with interferon-alpha (IFN-α) for hepatitis C virus (HCV) infection is associated with increased risk for depression.

Aims: To identify clinical predictors for IFN-α-induced depression during antiviral therapy for HCV infection.

Method: Depression (defined with the Montgomery-Åsberg Depression Rating Scale (MADRS)) was evaluated before and during antiviral treatment in 91 people with chronic HCV infection without a history of psychiatric disorders. Cognitive function was evaluated using the Trail Making Test A/B (TMT A/B). (Trial registration at NCT00136318.)

Results: Depression during antiviral therapy was significantly associated with a baseline MADRS score of 3 or higher (P = 0.006). In total, 89% (n = 16) of patients who had a baseline score >0 for the single item sadness developed depression. Poor baseline performance in the TMT A (P = 0.027) and TMT B (P = 0.033) was predictive for severe depression.

Conclusions: Pre-treatment screening for subthreshold depressive and cognitive symptoms will help to identify those at risk for IFN-α-associated depression among patients with chronic hepatitis C.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Antiviral Agents / adverse effects*
  • Cognitive Dysfunction / complications*
  • Depression / chemically induced*
  • Depression / complications*
  • Double-Blind Method
  • Hepatitis C, Chronic / complications*
  • Hepatitis C, Chronic / drug therapy
  • Hepatitis C, Chronic / psychology*
  • Humans
  • Interferon-alpha / adverse effects*
  • Risk Factors


  • Antiviral Agents
  • Interferon-alpha

Associated data