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Multicenter Study
, 11 (3), 426-433

Prevalence and Incidence of Depression During Interferon-Based Antiviral Therapy in Chronic Hepatitis C Patients in the Republic of Korea

Affiliations
Multicenter Study

Prevalence and Incidence of Depression During Interferon-Based Antiviral Therapy in Chronic Hepatitis C Patients in the Republic of Korea

Joo Yeong Baeg et al. Gut Liver.

Abstract

Background/aims: The association between depression and chronic hepatitis C virus (HCV) infection or pegylated interferon α and ribavirin therapy (PR therapy) has not been extensively studied in Korea. We aimed to clarify the prevalence of depression and its incidence during PR therapy in chronic hepatitis C (CHC) patients.

Methods: In this prospective, multicenter study, 114 CHC patients were screened for depression using two self-reported scales, the Beck Depression Inventory-I (BDI-I) and the Hospital Anxiety and Depression scale (HADS). The incidence of depression during PR therapy was evaluated in 62 patients who underwent PR therapy during the study period.

Results: The prevalence of baseline depression was 17.5% according to the BDI-I score ≥10 criterion and 4.4% according to the HADS-D score ≥8 criterion in the 114 CHC patients, and it was significantly associated with an unmarried state. During PR therapy, depression developed in 34.6% according to the BDI-I scale and 29.5% according to the HADS-D, which negatively affected sustained virologic response (SVR).

Conclusions: The prevalence of depression in Korean CHC patients appears to be low compared to that in Western patients; however, its incidence during PR therapy (approximately 30%) was similar to that of other populations, which led to a lower SVR rate. Active screening and multidisciplinary management of depression during PR therapy is warranted.

Keywords: Beck Depression Inventory-I; Depression; Hepacivirus; Hospital Anxiety and Depression scale; Interferons.

Conflict of interest statement

CONFLICTS OF INTEREST

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Development of depression during antiviral treatment. Depressive symptoms developed in 34.6% (n=18) with a BDI-I score ≥10 (A) and 29.5% (n=18) with a HADS-D score ≥8 (B) among 52 and 61 patients who had no depression at baseline, respectively. The point prevalence of moderate to severe depression (BDI-I score ≥16 and HADS-D ≥11) was 17.3% (n=9) according to the BDI-I score and 9.8% (n=6) according to the HADS-D score over the course of pegylated interferon and RBV therapy. The majority of patients exhibited increased BDI-I or HADS-D scores during treatment, which returned to normal after the completion of treatment. BDI-I, Beck Depression Inventory-I; HADS-D, Hospital Anxiety and Depression scale-Depression.
Fig. 2
Fig. 2
Cumulative incidence of depression during antiviral treatment with pegylated interferon α and ribavirin. The cumulative incidence rates of depression during antiviral therapy were 21.5% versus 21.5% at 12 weeks, 30.4% versus 27.2% at 24 weeks, 38.3% versus 34.2% at 36 weeks according to BDI-I (A) versus HADS-D (B), respectively. BDI-I, Beck Depression Inventory-I; HADS-D, Hospital Anxiety and Depression scale-Depression; FU, follow-up; Pt., patients.
Fig. 3
Fig. 3
Changes in the Beck Depression Inventory-I (BDI-I) score during pegylated interferon and ribavirin therapy among patients with underlying depression at baseline. Seven patients with pretreatment depression showed aggravation of the BDI-I score during antiviral therapy, and two patients (number 2 and number 10) received antidepressant therapy. Moreover, one patient did not recover after 6 months from the end of pegylated interferon α and ribavirin therapy.

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