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Tesi etd-04032009-120536


Tipo di tesi
Tesi di dottorato di ricerca
Autore
CARLINI, MARINA
URN
etd-04032009-120536
Titolo
CORRELATIONS BETWEEN LIFETIME MANIC SYMPTOMS AND DEPRESSION DURING INTERFERON TREATMENT IN HCV+ PATIENTS WITHOUT CURRENT OR LIFETIME MENTAL DISORDERS
Settore scientifico disciplinare
MED/25
Corso di studi
NEUROBIOLOGIA E CLINICA DEI DISTURBI AFFETTIVI
Relatori
Relatore Prof. Dell'Osso, Liliana
Parole chiave
  • Depression
  • HCV+ patients
  • Interferon treatment
  • Subthreshold mania
Data inizio appello
30/04/2009
Consultabilità
Non consultabile
Data di rilascio
30/04/2049
Riassunto
Background: Depression is considered the most frequent interferon (IFN)-a-induced psychiatric disorder. However, other neuropsychiatric side effects of IFN treatment, such as irritability, anxiety, and manic episodes, are reported as well. We analyzed the impact of lifetime manic–hypomanic symptoms and anxiety on the development of depression in hepatitis-C-virus-infected subjects treated with two different types of IFN-α.
Methods: Psychiatric diagnostic assessment was conducted at baseline using the Structured Clinical Interview for DSMIV for Axis I DSM-IV Disorders, patient edition (SCID-I/P), to confirm the absence of any current or lifetime psychiatric disorders. During treatment, subjects were administered interviewer-based instruments, such as the Brief Psychiatric Rating Scale (BPRS), the Clinical Global Impressions Scale (CGI), the Bech-Rafaelsen Mania-Melancholia Scale (BRMMS) and a set of self-report instruments such as the Mood Spectrum Self-Report Version (MOODS-SR), the State-Trait Anxiety Inventory (STAI), and the Medical Outcomes Study short-form 36 (SF-36).
Results: Six (12%) of 49 individuals with a negative history of psychiatric disorders developed major depression during treatment with IFN. The onset of depression was significantly associated with the presence of lifetime subthreshold manic–hypomanic symptoms. Subjects exceeding manic threshold were more likely to develop depression than those below threshold (33.3% vs. 7.5%, P=.033). Of these six patients, two dropped out because severity of depression was not compatible with prosecution of IFN treatment The remaining four patients were treated with citalopram and achieved remission by the fifth month of treatment and completed the study.
Conclusions: Our data suggest that individuals treated with IFN with no past history of mental disorders are more likely to develop depression if they experienced subthreshold manic–hypomanic symptoms in their lifetime. These findings derive from an exploratory study and may have important implications for the prevention of IFN-induced depression if replicated in larger studies and remark the usefulness of the MOODS-SR instrument to identify phenotypes at risk of depression.
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