Depression in hepatitis C patients is often overlooked in routine clinical interviews. Such a failure on the part of the doctors to recognize the problem could affect the outcome of the treatment, warn researchers from Denmark, Sweden, Norway and Finland (the NORDynamIC project group).
A second U.S. study found that patients with chronic infection had lower (work) productivity and incurred higher medical benefit costs than those without HCV. Both studies are available in the August issue of Hepatology, a journal published by Wiley-Blackwell on behalf of the American Association for the Study of Liver Diseases (AASLD).
HCV is a blood-born infection causing inflammation and destruction of liver cells. When inflammation lasts longer than six months there is ongoing liver cell injury which is defined as chronic HCV. The standard treatment protocol for chronic HCV is weekly injections of peg-interferon alfa-2a in combination with daily oral ribavirin for 24 to 48 weeks. However, this combination treatment can lead to major depression or other psychiatric complications in a number of HCV patients which may require premature termination of the antiviral therapy.
Peter Leutscher, M.D., Ph.D., and colleagues estimated the value of routine medical interviews in diagnosing depression in chronic HCV patients receiving peg-interferon/ribavirin therapy using the Major Depression Inventory (MDI). The MDI is a self-rating depression scale with a dual functionality in diagnosing major depression and in measurement of depression severity. Of the 325 HCV patients enrolled in the study, 6% were observed with major depression at baseline. Among the remaining 306 patients, 37% (n=114) developed depression while on HCV combination therapy. “According to the MDI criteria, we found that only 32% of the 114 patients with major depression were correctly diagnosed during routine medical interviews,” noted Dr. Leutscher.
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