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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study examined the incidence, clinical course and its risk factors for major depression in patients with chronic hepatitis type C undergoing interferon-alpha therapy. Ninety-nine subjects underwent the psychiatric interviews for diagnosis of major depressive episode according to the DSM-IV criteria before the start of interferon therapy, and once every 4 weeks during both the 24-week treatment period and 12 weeks after the end of therapy. Depressive symptoms were also evaluated using the Hamilton Rating Scale for Depression. Major depression occurred during interferon therapy in 23 patients (23.2%). In 73.9% of them depression occurred within 8 weeks after the start of therapy. Twenty-two patients with depression completed the therapy and 59.1% of them achieved remission by the end of therapy with a mean duration of 11.6 weeks. Although the other 40.9% were not in remission at the end of therapy, they achieved remission within 12 weeks thereafter. The only risk factor for depression was advanced age. Depression occurs frequently among patients with hepatitis type C undergoing interferon-alpha therapy. Such patients require careful observation, and psychiatrists should be sufficiently aware of this significant psychiatric complication of interferon therapy.
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PMID:Incidence and clinical course of major depression in patients with chronic hepatitis type C undergoing interferon-alpha therapy: a prospective study. 1258 26

A number of studies have reported an association between chronic hepatitis C (HCV) infection and significant impairments in health-related quality of life (QOL), which are independent of the severity of liver disease. There are numerous reports documenting the prevalence of symptoms such as fatigue and depression in chronic HCV infection, which may in part account for the reductions in quality of life. Although there are a large number of potential explanations for these symptoms, including depression and anxiety associated with the diagnosis of HCV infection or substance abuse, there has been recent interest in the possibility of a biological effect of HCV infection on cerebral function. There is emerging evidence of mild, but significant neurocognitive impairment in HCV infection, which cannot be attributed to substance abuse, coexistent depression or hepatic encephalopathy. In vivo magnetic resonance spectroscopy and neurophysiological studies have suggested that a biological mechanism may underlie these cognitive findings. The recent detection of HCV genetic sequences in post mortem brain tissue raises the intriguing possibility that HCV infection of the central nervous system may be related to the reported neuropsychological symptoms and cognitive impairment.
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PMID:Cerebral dysfunction in chronic hepatitis C infection. 1261 63

Pegylation of interferon-alpha-2a is associated with improved sustained virological response rates in patients with chronic hepatitis C. Subsequently, combination therapy with peginterferon-alpha-2a (40kD) [Pegasys] and ribavirin (Copegus trade mark, Rebetol) was investigated to establish if the efficacy of peginterferon-alpha-2a (40kD) monotherapy could be further enhanced. Subcutaneous peginterferon-alpha-2a (40kD) was administered at a dosage of 180 micro g once weekly and oral ribavirin was usually administered at a dosage of 1000 or 1200 mg/day. In treatment-naive patients with chronic hepatitis C, the sustained virological response rate (assessed 24 weeks after the end of a 48-week treatment period) was significantly higher in peginterferon-alpha-2a (40kD) plus ribavirin recipients than in peginterferon-alpha-2a (40kD) plus placebo recipients or interferon-alpha-2b plus ribavirin recipients (56% vs 29% and 44%). Retrospective analysis revealed that peginterferon-alpha-2a (40kD) plus ribavirin recipients who did not achieve an early virological response were unlikely to achieve a sustained response. Treatment with peginterferon-alpha-2a (40kD) plus another antiviral agent (ribavirin, mycophenolate mofetil, amantadine, or ribavirin and amantadine) was beneficial in patients with chronic hepatitis C who had relapsed during or after, or had not responded to, treatment with interferon-alpha-2b plus ribavirin. In the relapse study, sustained virological response rates in recipients of peginterferon-alpha-2a (40kD) plus ribavirin were 45% with and 38% without amantadine. Peginterferon-alpha-2a (40kD) plus ribavirin appears beneficial in patients with chronic hepatitis C considered difficult to treat (e.g. patients infected with hepatitis C virus genotype 4, African-American patients, patients with advanced fibrosis or cirrhosis and patients co-infected with HIV). Flu-like symptoms and depression occurred significantly less frequently with peginterferon-alpha-2a (40kD) plus ribavirin than with interferon-alpha-2b plus ribavirin. Similar proportions of patients receiving peginterferon-alpha-2a (40kD) plus ribavirin, peginterferon-alpha-2a (40kD) plus placebo and interferon-alpha-2b plus ribavirin withdrew from treatment because of laboratory abnormalities or other adverse events. In conclusion, combination therapy comprising subcutaneous peginterferon-alpha-2a (40kD) and oral ribavirin is an important new treatment option for chronic hepatitis C. Peginterferon-alpha-2a (40kD) plus oral ribavirin is significantly more effective than peginterferon-alpha-2a (40kD) monotherapy or interferon-alpha-2b plus ribavirin at inducing a sustained virological response in treatment-naive patients with chronic hepatitis C. Preliminary data suggest that peginterferon-alpha-2a (40kD) plus ribavirin is also beneficial in treatment-experienced patients and in patients who have traditionally been considered difficult to treat. Combination therapy with peginterferon-alpha-2a (40kD) and oral ribavirin is poised to become a valuable first-line treatment option in chronic hepatitis C.
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PMID:Peginterferon-alpha-2a (40kD) plus ribavirin: a review of its use in the management of chronic hepatitis C. 1265 50

We aimed to evaluate the effect of chronic hepatitis B virus infection on the psychological state of children. Children who were carriers of hepatitis B virus (n:20) and those with chronic hepatitis B virus infection (n:20) for at least one year formed study Groups 1 and 2, respectively. Healthy children with similar demographic characteristics (n:43) were enrolled as the control group. The "Children's Depression Inventory" and "State-Trait Anxiety Inventory for Children" were used for the assessment of the extent of depression and anxiety, respectively. Then, mean depression and anxiety scores of the study and control groups were compared. In addition, the children in each group were further evaluated for depression and anxiety with respect to gender and age as prepubertal and postpubertal. The mean depression and anxiety scores of study Groups 1 and 2 and of the control group were 8.35 +/- 5.6, 8.22 +/- 6.85, 9.12 +/- 5.2 (depression scores) and 32.7 +/- 6.85, 33.4 +/- 10 and 34 +/- 6.5 (anxiety scores), respectively. These three groups did not differ significantly from each other with respect to anxiety and depression scores (p>0.05). Athough there was no child with overt depression (with a depression score over 19) in study Group 2, two children in study Group 1 and one child in the control group were determined to be in overt depression. Children with chronic hepatitis B virus infection were not different with respect to depression and anxiety from children who were carriers of hepatitis B virus nor from the healthy controls.
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PMID:Depression and anxiety in chronic hepatitis B: effect of hepatitis B virus infection on psychological state in childhood. 1271 67

The use of interferon (IFN)-alpha for the treatment of viral diseases or cancers is associated with neuropsychiatric side effects in a large number of patients. The mechanisms by which cytokines induce these symptoms, as well as the vulnerability factors for these effects, have not been yet fully elucidated. Systematic clinical studies, combining biochemical approaches, functional brain imaging and treatment intervention, have been initiated to better understand the phenomenology, pathophysiology, and preventive strategies of the neuropsychiatric effects of IFN-alpha in patients with malignant melanoma or chronic hepatitis C. The findings indicate differential phenomenology and treatment responsiveness of the neurovegetative and mood/cognitive symptoms induced by IFN-alpha, suggesting distinct underlying mechanisms. Impaired neuroendocine function, fronto-striatal dysfunction and decreased monoamine were found to contribute to the pathophysiology of core symptoms of IFN-alpha-induced depression, including symptoms of mood alterations, cognitive dysfunction, anhedonia and psychomotor retardation. In addition, some behavioral and biological markers of the vulnerability for IFN-alpha-induced depression were identified. These findings provide important information concerning the relationship between cytokines and depression.
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PMID:[Neuro-immune interactions in psychopathology with the example of interferon-alpha-induced depression]. 1291 Jun 30

Shosaikoto, a Kampo medicine used clinically to treat patients with chronic hepatitis or cirrhosis in Japan, displays immunoregulatory effects, especially on macrophage functions. Oral administration of shosaikoto influences the synthesis of humoral factors such as the interleukins, nitric oxide and prostaglandins in macrophages. In addition, phagocytic activity is enhanced by treatment with shosaikoto, resulting in an antigen that is effectively presented to T lymphocytes to produce more antibodies. The role of macrophages in the pathogenesis of atherosclerosis is well recognized, although a therapeutic agent targeted at macrophages has not yet been developed. When shosaikoto was administered to atherosclerotic rabbits, it did not exhibit antihyperlipidemic effects but did reduce the formation of atherosclerotic lesions. In addition, treatment with shosaikoto suppressed intimal hyperplasia in apoE-deficient mice fed a cholesterol-enriched diet for nine weeks. Biochemical studies demonstrated that the mechanism of the antiatherosclerotic effect was partly due to the increase of oxidized low-density lipoprotein (oxLDL) elimination by macrophages, resulting from stimulation of oxLDL uptake through scavenger receptors, activation of acyl-CoA:cholesterol acyltransferase and neutral cholesteryl ester hydrolase, and increase of cholesterol elimination by high-density lipoprotein. Furthermore, shosaikoto is able to reverse the depression of macrophage functions caused by hyperlipidemia. These results indicate the potential of this medicine as a new type of preventive or therapeutic agent for atherosclerosis.
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PMID:Shosaikoto as a potential antiatherosclerotic agent. 1293 13

Interferon alpha (IFN-alpha), an immunomodulatory cytokine, is used for the treatment of several disorders including chronic hepatitis or malignant melanoma. During the therapy IFN-alpha may cause severe neuropsychiatric syndromes including depression with suicidal ideation, paranoid psychoses or confusional states. The reasons and management of these side effects are widely unknown. The underlying pathogenetic mechanisms include various effects on neuroendocrine, cytokine and neurotransmitter systems. This review summarizes therapeutic strategies against IFN-alpha associated psychiatric syndromes. Zolpidem or Zopiclon can be used for the treatment of sleeping disturbances. Serotonin-reuptake-inhibitors including citalopram or paroxetine were shown to be effective for acute treatment of IFN-alpha associated depression. The efficacy of prophylactic treatment for prevention of IFN-alpha induced depression has to be proven in future trials. In an interdisciplinary setting, psychiatric disorders and drug addiction should not prevent patients from interferon-alpha treatment. Furthermore, interdisciplinary care should improve quality of life, adherence and therapeutic outcome of interferon-alpha treated patients.
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PMID:[Incidence, pathoetiology and treatment of interferon-alpha induced neuro-psychiatric side effects]. 1297 32

Psychiatric symptoms related to interferon (IFN) treatment for chronic hepatitis have been a crucial issue in consultation liaison psychiatry. In this report we present a hypothesis regarding the development of psychiatric symptoms. There were marked differences in the incidence of psychiatric symptoms among studies. This may be because psychiatric symptoms are readily overlooked in routine practice in the Department of Internal Medicine, and because IFN treatment frequently causes transient depression. It was speculated that psychiatric intervention was required in 10-19% of the patients. We found that among psychiatric symptoms related to IFN treatment, depression with irritation and anxiety was commonly observed. In many case reports, mood disorder was noted as a precursory or residual symptom of delirium and hallucination/delusion. We present management guidelines for psychiatric symptoms in IFN treatment, and propose that self-assessment scaling should be performed before and during treatment to detect psychiatric symptoms in the early stage, and that patients with suspected symptoms should be promptly referred to the Department of Psychiatry. We introduce an open study of antidepressant treatment for depression related to IFN treatment, and recommend aggressive administration of antidepressants. IFN treatment should be discontinued in patients with: moderate or severe suicidal ideation or suicide attempt, depression that does not respond to antidepressant treatment, manic state, hallucination/delusion, or delirium.
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PMID:[Psychiatric symptoms related to interferon treatment for chronic hepatitis]. 1456 May 93

It has been postulated that interferon induces depression via a nitric oxide-related system. The purpose of this study was to test whether there was a difference in the effects of interferon-alpha (IFN-alpha) on nitric oxide production between patients with and without interferon-induced depression. The subjects had chronic hepatitis C and were being treated with IFN-alpha. We measured plasma nitrate, a marker of nitric oxide production in vivo, before, during, and after interferon therapy. Of 146 patients, 9 developed depression within the first 4 wk of interferon therapy, and 8 developed depression later. In the former group, a significant plasma nitrate increase was observed during therapy, followed by a decrease to baseline after discontinuation. This, however, was not the case with the latter group or those who had no psychiatric symptoms. These results suggest nitric oxide involvement in at least some forms of IFN-alpha-induced depression.
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PMID:Nitric oxide involvement in depression during interferon-alpha therapy. 1460 57

In experiments on 182 white male rats hepatitis was modelled by percutaneous injection of 0.1 ml/500 g of tetrachloromethane (TCM) dissolved in olive oil. TCM was injected every other day for 65 days. After development of hepatitis (in 65 days) synthesis of glutamine and urea, partial oxygen pressure in the liver were studied. It is shown that modelling of chronic hepatitis leads to impairment of glutamine and urea synthesis, reduction of tissue blood flow and oxygen partial pressure. It is suggested that the reason of these changes is inhibition activity of glutamate dehydrogenase, arginase and short-term depression activity of phosphate-dependent glutaminase. The changes in the enzymatic activity lead to lowering tissue level of glutamine, urea, accumulation of ammonia ions. These changes persist for 14 days after the last injection of tetrachloromethane.
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PMID:[The ammonia neutralization function of the liver in chronic active hepatitis]. 1505 75


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