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J Psychosom Res. 2015 Feb;78(2):184-92. doi: 10.1016/j.jpsychores.2014.07.020. Epub 2014 Aug 7.

A longitudinal study evaluating the effects of interferon-alpha therapy on cognitive and psychiatric function in adults with chronic hepatitis C.

Author information

1
Research & Development Service, Portland VA Medical Center, 3710 SW U.S. Veterans Hospital Rd., Portland, OR 97239, USA; Mental Health and Clinical Neurosciences Division, Portland VA Medical Center, 3710 SW U.S. Veterans Hospital Rd., Portland, OR 97239, USA; Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, USA. Electronic address: marilyn.huckans@va.gov.
2
Mental Health and Clinical Neurosciences Division, Portland VA Medical Center, 3710 SW U.S. Veterans Hospital Rd., Portland, OR 97239, USA; Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, USA.
3
Research & Development Service, Portland VA Medical Center, 3710 SW U.S. Veterans Hospital Rd., Portland, OR 97239, USA; School of Professional Psychology, Pacific University, 190 SE 8th Ave., Hillsboro, OR 97123, USA.
4
Research & Development Service, Portland VA Medical Center, 3710 SW U.S. Veterans Hospital Rd., Portland, OR 97239, USA; Graduate Department of Clinical Psychology, George Fox University, 414 N. Meridian St. #V104, Newberg, OR 97132, USA.
5
Research & Development Service, Portland VA Medical Center, 3710 SW U.S. Veterans Hospital Rd., Portland, OR 97239, USA.
6
Gastroenterology Service, Portland VA Medical Center, 3710 SW US Veterans Hospital Rd., Portland, OR 97239, USA; Department of Internal Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland OR 97239, USA.
7
Portland Gastroenterology Division, Oregon Clinic, 9280 SE Sunnybrook Blvd., Clackamas, OR 97015, USA.
8
Research & Development Service, Portland VA Medical Center, 3710 SW U.S. Veterans Hospital Rd., Portland, OR 97239, USA; Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, USA.

Abstract

OBJECTIVE:

To prospectively evaluate for changes in objective cognitive performance (attention, memory, and executive function) and psychiatric symptom severity (depression, anxiety, fatigue, and pain) in patients before, during and after interferon-alpha based therapy (IFN) for chronic hepatitis C virus infection (HCV).

METHODS:

33 HCV+ adults were evaluated two months before IFN initiation (baseline), three months into IFN, and six months following IFN termination (IFN+ Group). 31 HCV+ adults who did not undergo IFN therapy were evaluated at baseline and six months later (IFN- Group). At each evaluation, participants completed the Neuropsychological Assessment Battery (NAB) Attention, Memory and Executive Functions Modules, the Beck Depression Inventory, Second Edition (BDI), Generalized Anxiety Disorder Inventory (GADI), Fatigue Severity Scale (FSS), and Brief Pain Inventory (BPI).

RESULTS:

Compared with the IFN- Group, the IFN+ Group experienced significantly (p<0.050) increased symptoms of depression, anxiety, fatigue and pain during IFN therapy relative to baseline. In the IFN+ Group, psychiatric symptoms generally returned to baseline levels following IFN termination. Sustained viral response was associated with significantly lower depression and fatigue. No significant changes in cognitive performance were observed.

CONCLUSIONS:

During IFN, patients with HCV evidence significantly increased psychiatric symptoms, including symptoms of depression, anxiety, fatigue and pain. These psychiatric symptoms are generally short-term and remit following IFN termination, with increased benefit if viral clearance is achieved. However, IFN is not associated with significant declines in objective cognitive performance during or following IFN.

KEYWORDS:

Anxiety; Cognition; Depression; Fatigue; Hepatitis C; Interferon; Pain

PMID:
25219976
PMCID:
PMC4435678
DOI:
10.1016/j.jpsychores.2014.07.020
[Indexed for MEDLINE]
Free PMC Article

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