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Risk factors for the development of depression in patients with hepatitis C taking interferon-α.

Smith KJ, Norris S, O'Farrelly C, O'Mara SM - Neuropsychiatr Dis Treat (2011)

Bottom Line: Interferon-α, currently used for the treatment of hepatitis C, is associated with a substantially elevated risk of depression.The identification of risk factors prior to treatment may allow identification of patients who will become depressed on interferon, allowing the possibility of improved treatment support and rates of treatment adherence.Here, we consolidate and review the literature on risk factors, and we discuss the potential confounds within the research examined in order to better isolate the risk factors that may be important in the development of depression in these patients and which might help predict patients likely to become depressed on treatment.

View Article: PubMed Central - PubMed

Affiliation: Trinity College Institute of Neuroscience.

ABSTRACT
Interferon-α, currently used for the treatment of hepatitis C, is associated with a substantially elevated risk of depression. However, not everyone who takes this drug becomes depressed, so it is important to understand what particular factors may make some individuals more 'at risk' of developing depression than others. Currently there is no consensus as to why interferon-induced depression occurs and the range of putative risk factors is wide and diverse. The identification of risk factors prior to treatment may allow identification of patients who will become depressed on interferon, allowing the possibility of improved treatment support and rates of treatment adherence. Here, we consolidate and review the literature on risk factors, and we discuss the potential confounds within the research examined in order to better isolate the risk factors that may be important in the development of depression in these patients and which might help predict patients likely to become depressed on treatment. We suggest that interactions between psychobehavioral, genetic, and biological risk factors are of particular importance in the occurrence of depression in patients with hepatitis C taking interferon-α.

No MeSH data available.


Related in: MedlinePlus

Interaction of risk factors. Model by which various risk factors could interact to possibly produce depression in those patients taking IFN-α. It is possible that administration of IFN-α could lead to some underlying genetic vulnerability (eg, the short allele in 5-HTLLPR) impacting upon levels of a chemical such as tryptophan. This vulnerability, along with the biological response it could induce, would also interact with a psychiatric vulnerability. As these people have the genetic vulnerability, they are more likely to be depressed at baseline and/or have had a history of psychiatric disorders. All this would lead the person to be vulnerable to developing depression following administration of IFN.
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f3-ndt-7-275: Interaction of risk factors. Model by which various risk factors could interact to possibly produce depression in those patients taking IFN-α. It is possible that administration of IFN-α could lead to some underlying genetic vulnerability (eg, the short allele in 5-HTLLPR) impacting upon levels of a chemical such as tryptophan. This vulnerability, along with the biological response it could induce, would also interact with a psychiatric vulnerability. As these people have the genetic vulnerability, they are more likely to be depressed at baseline and/or have had a history of psychiatric disorders. All this would lead the person to be vulnerable to developing depression following administration of IFN.

Mentions: The current climate of psychiatric research is one where there is an acknowledgment of the multidisciplinary factors that play into any psychiatric disorder. Current research is, therefore, focused on finding interactions between genetic, biological, demographic, and psychobehavioral factors that lead some people to be more vulnerable to developing psychiatric disorders than others. It would be very difficult to identify a single risk factor that would lead people to be more susceptible to becoming depressed on IFN-α than others. However, the most convincing research conducted in this area is that which has examined biological,41,57,58 genetic,89,91–93 and psychobehavioral41,62,77,92,97 risk factors, and it is no surprise that these three risk factors interact with one another (for an example of the way these three risk factors could interact to produce depression, see Figure 3).


Risk factors for the development of depression in patients with hepatitis C taking interferon-α.

Smith KJ, Norris S, O'Farrelly C, O'Mara SM - Neuropsychiatr Dis Treat (2011)

Interaction of risk factors. Model by which various risk factors could interact to possibly produce depression in those patients taking IFN-α. It is possible that administration of IFN-α could lead to some underlying genetic vulnerability (eg, the short allele in 5-HTLLPR) impacting upon levels of a chemical such as tryptophan. This vulnerability, along with the biological response it could induce, would also interact with a psychiatric vulnerability. As these people have the genetic vulnerability, they are more likely to be depressed at baseline and/or have had a history of psychiatric disorders. All this would lead the person to be vulnerable to developing depression following administration of IFN.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3101888&req=5

f3-ndt-7-275: Interaction of risk factors. Model by which various risk factors could interact to possibly produce depression in those patients taking IFN-α. It is possible that administration of IFN-α could lead to some underlying genetic vulnerability (eg, the short allele in 5-HTLLPR) impacting upon levels of a chemical such as tryptophan. This vulnerability, along with the biological response it could induce, would also interact with a psychiatric vulnerability. As these people have the genetic vulnerability, they are more likely to be depressed at baseline and/or have had a history of psychiatric disorders. All this would lead the person to be vulnerable to developing depression following administration of IFN.
Mentions: The current climate of psychiatric research is one where there is an acknowledgment of the multidisciplinary factors that play into any psychiatric disorder. Current research is, therefore, focused on finding interactions between genetic, biological, demographic, and psychobehavioral factors that lead some people to be more vulnerable to developing psychiatric disorders than others. It would be very difficult to identify a single risk factor that would lead people to be more susceptible to becoming depressed on IFN-α than others. However, the most convincing research conducted in this area is that which has examined biological,41,57,58 genetic,89,91–93 and psychobehavioral41,62,77,92,97 risk factors, and it is no surprise that these three risk factors interact with one another (for an example of the way these three risk factors could interact to produce depression, see Figure 3).

Bottom Line: Interferon-α, currently used for the treatment of hepatitis C, is associated with a substantially elevated risk of depression.The identification of risk factors prior to treatment may allow identification of patients who will become depressed on interferon, allowing the possibility of improved treatment support and rates of treatment adherence.Here, we consolidate and review the literature on risk factors, and we discuss the potential confounds within the research examined in order to better isolate the risk factors that may be important in the development of depression in these patients and which might help predict patients likely to become depressed on treatment.

View Article: PubMed Central - PubMed

Affiliation: Trinity College Institute of Neuroscience.

ABSTRACT
Interferon-α, currently used for the treatment of hepatitis C, is associated with a substantially elevated risk of depression. However, not everyone who takes this drug becomes depressed, so it is important to understand what particular factors may make some individuals more 'at risk' of developing depression than others. Currently there is no consensus as to why interferon-induced depression occurs and the range of putative risk factors is wide and diverse. The identification of risk factors prior to treatment may allow identification of patients who will become depressed on interferon, allowing the possibility of improved treatment support and rates of treatment adherence. Here, we consolidate and review the literature on risk factors, and we discuss the potential confounds within the research examined in order to better isolate the risk factors that may be important in the development of depression in these patients and which might help predict patients likely to become depressed on treatment. We suggest that interactions between psychobehavioral, genetic, and biological risk factors are of particular importance in the occurrence of depression in patients with hepatitis C taking interferon-α.

No MeSH data available.


Related in: MedlinePlus