Prevalence of depression after treatment with conventional interferon’s and ribavirin therapy in patients with hepatitis C using PHQ-9
Attiya Sabeen Rahman, Muhammad Amir, Shaista Ahmed, Qaiser Jamal, Mehwish Riaz, Muhammad A. Siddiqui
Objective: Patients with Hepatitis C infections suffer commonly from interferon-alphainduced depression and severe psychiatric disorders. The main purpose of this study was to determine the prevalence of depression in patients with hepatitis C infection after treatment with conventional interferon’s and ribavirin.
Methods: The cross-sectional study was conducted from June 2015 to May 2017 in a tertiary care hospital in Karachi. Two Residents from Department of Medicine were trained to take patients’ history and conduct interview according to the Patient Health Questionnaire- 9 (PHQ-9). A favorable ethical opinion was obtained from the Institutional Ethical Review Committee and after taking informed consent, patient’s short history was initially taken. Depression and its severity were also seen and compared between genders.
Results: Fifteen hundred and seventy-one (n = 1,571) participants who met the study’s inclusion criteria were participated, of which 41.5% (n = 652) participants were male and 58.8% (n = 919) were female. Average treatment duration of the study participants was 5.56 ± 1.04 months ranged from 1 to 9 months. Overall, more than two-thirds of participants were having mild (38.1%) and moderate (48.9%) depression. Participants were asked multiple questions regarding self-reporting depression component. Most of the participants reported that they experience little interest or pleasure in doing things (70.8%) and having trouble falling or staying asleep or sleeping too much (39.2%) for more than half a day. Similarly, more than half of the participants having difficulty on concentrating things such as reading the newspaper or watching television (58.6%). However, the majority of participant do not think that it would be better off dead or of hurting their self (73%). Out of 1,571 patients, 38.1% had mild depression and 48.9% of patients had moderate depression. Among male participants, 40.5% had mild and 48.2% had moderate depression. In contrast, among female participants, 36.3% had mild and 49.5% had moderate depression. Prevalence of depression among patients with hepatitis C was not found to be associated with gender [χ2(4) = 7.5, p < 0.11].
Conclusion: The prevalence of depression in patients with hepatitis C appears to be very high compared to that in Western patients. Interferon (IFN) α- and ribavirin-induced depression were seen after 24 weeks of treatment; however, different study reports that depressive events with IFN α and ribavirin occurred more frequently during the first 24 weeks of therapy than during the later period of 48 weeks. Active screening and multidisciplinary management of depression is warranted.