Prevalence and impact of manic traits in depressed patients initiating interferon therapy for chronic hepatitis C infection

Carmen Lim, Jeff Olson, Atif Zaman, Jim Phelps, Kenneth D. Ingram

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

GOALS: To evaluate the impact of manic traits on adverse events in depressed hepatitis C patients initiating interferon therapy. BACKGROUND: Interferon α therapy for hepatitis C can exacerbate preexisting depression. Bipolar disorder frequently presents as depressive symptoms that are indistinguishable from or misdiagnosed as major depressive disorder. The impact of bipolar disorder on adverse psychiatric events during therapy is unknown. STUDY: A retrospective study was performed on consecutive patients initiating interferon therapy in the Hepatology clinic at a tertiary-care center between December 2004 and October 2007. All patients completed the Physicians Health Questionnaire (PHQ-9), a validated survey for major depressive disorder. Patients with a positive PHQ screen completed the Mood Disorders Questionnaire (MDQ), a validated screening tool for manic traits. Patients with a negative PHQ served as controls. All adverse psychiatric events were documented through retrospective record review for 6 months after interferon initiation. RESULTS: A total of 165 patients were treated with interferon α. One hundred thirty-two (80%) had a negative PHQ (controls) and 33 had a positive PHQ. Forty-one (30%) of the control patients had adverse psychiatric events. Psychiatric events occurred in 8 of 22 (36%) patients with positive PHQ but negative MDQ; 8 of 11 (73%) with positive PHQ and positive MDQ had psychiatric adverse events. This finding was statistically significant compared with the control group (P=0.007). The overall sustained viral response rate was 58% and was not statistically significant among groups. CONCLUSIONS: Baseline manic traits, as detected by the MDQ, were associated with high rates of adverse psychiatric events among individuals receiving antiviral therapy.

Original languageEnglish (US)
JournalJournal of Clinical Gastroenterology
Volume44
Issue number7
DOIs
StatePublished - Aug 2010

Fingerprint

Chronic Hepatitis C
Interferons
Psychiatry
Infection
Mood Disorders
Major Depressive Disorder
Therapeutics
Hepatitis C
Bipolar Disorder
Depression
Gastroenterology
Diagnostic Errors
Tertiary Care Centers
Antiviral Agents
Surveys and Questionnaires
Retrospective Studies
Physicians
Control Groups
Health

Keywords

  • bipolar disorder
  • chronic hepatitis C
  • depression
  • interferon α therapy

ASJC Scopus subject areas

  • Gastroenterology
  • Medicine(all)

Cite this

Prevalence and impact of manic traits in depressed patients initiating interferon therapy for chronic hepatitis C infection. / Lim, Carmen; Olson, Jeff; Zaman, Atif; Phelps, Jim; Ingram, Kenneth D.

In: Journal of Clinical Gastroenterology, Vol. 44, No. 7, 08.2010.

Research output: Contribution to journalArticle

@article{8611596a7c8143b299fbd21cc622297b,
title = "Prevalence and impact of manic traits in depressed patients initiating interferon therapy for chronic hepatitis C infection",
abstract = "GOALS: To evaluate the impact of manic traits on adverse events in depressed hepatitis C patients initiating interferon therapy. BACKGROUND: Interferon α therapy for hepatitis C can exacerbate preexisting depression. Bipolar disorder frequently presents as depressive symptoms that are indistinguishable from or misdiagnosed as major depressive disorder. The impact of bipolar disorder on adverse psychiatric events during therapy is unknown. STUDY: A retrospective study was performed on consecutive patients initiating interferon therapy in the Hepatology clinic at a tertiary-care center between December 2004 and October 2007. All patients completed the Physicians Health Questionnaire (PHQ-9), a validated survey for major depressive disorder. Patients with a positive PHQ screen completed the Mood Disorders Questionnaire (MDQ), a validated screening tool for manic traits. Patients with a negative PHQ served as controls. All adverse psychiatric events were documented through retrospective record review for 6 months after interferon initiation. RESULTS: A total of 165 patients were treated with interferon α. One hundred thirty-two (80{\%}) had a negative PHQ (controls) and 33 had a positive PHQ. Forty-one (30{\%}) of the control patients had adverse psychiatric events. Psychiatric events occurred in 8 of 22 (36{\%}) patients with positive PHQ but negative MDQ; 8 of 11 (73{\%}) with positive PHQ and positive MDQ had psychiatric adverse events. This finding was statistically significant compared with the control group (P=0.007). The overall sustained viral response rate was 58{\%} and was not statistically significant among groups. CONCLUSIONS: Baseline manic traits, as detected by the MDQ, were associated with high rates of adverse psychiatric events among individuals receiving antiviral therapy.",
keywords = "bipolar disorder, chronic hepatitis C, depression, interferon α therapy",
author = "Carmen Lim and Jeff Olson and Atif Zaman and Jim Phelps and Ingram, {Kenneth D.}",
year = "2010",
month = "8",
doi = "10.1097/MCG.0b013e3181dc24f8",
language = "English (US)",
volume = "44",
journal = "Journal of Clinical Gastroenterology",
issn = "0192-0790",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

TY - JOUR

T1 - Prevalence and impact of manic traits in depressed patients initiating interferon therapy for chronic hepatitis C infection

AU - Lim, Carmen

AU - Olson, Jeff

AU - Zaman, Atif

AU - Phelps, Jim

AU - Ingram, Kenneth D.

PY - 2010/8

Y1 - 2010/8

N2 - GOALS: To evaluate the impact of manic traits on adverse events in depressed hepatitis C patients initiating interferon therapy. BACKGROUND: Interferon α therapy for hepatitis C can exacerbate preexisting depression. Bipolar disorder frequently presents as depressive symptoms that are indistinguishable from or misdiagnosed as major depressive disorder. The impact of bipolar disorder on adverse psychiatric events during therapy is unknown. STUDY: A retrospective study was performed on consecutive patients initiating interferon therapy in the Hepatology clinic at a tertiary-care center between December 2004 and October 2007. All patients completed the Physicians Health Questionnaire (PHQ-9), a validated survey for major depressive disorder. Patients with a positive PHQ screen completed the Mood Disorders Questionnaire (MDQ), a validated screening tool for manic traits. Patients with a negative PHQ served as controls. All adverse psychiatric events were documented through retrospective record review for 6 months after interferon initiation. RESULTS: A total of 165 patients were treated with interferon α. One hundred thirty-two (80%) had a negative PHQ (controls) and 33 had a positive PHQ. Forty-one (30%) of the control patients had adverse psychiatric events. Psychiatric events occurred in 8 of 22 (36%) patients with positive PHQ but negative MDQ; 8 of 11 (73%) with positive PHQ and positive MDQ had psychiatric adverse events. This finding was statistically significant compared with the control group (P=0.007). The overall sustained viral response rate was 58% and was not statistically significant among groups. CONCLUSIONS: Baseline manic traits, as detected by the MDQ, were associated with high rates of adverse psychiatric events among individuals receiving antiviral therapy.

AB - GOALS: To evaluate the impact of manic traits on adverse events in depressed hepatitis C patients initiating interferon therapy. BACKGROUND: Interferon α therapy for hepatitis C can exacerbate preexisting depression. Bipolar disorder frequently presents as depressive symptoms that are indistinguishable from or misdiagnosed as major depressive disorder. The impact of bipolar disorder on adverse psychiatric events during therapy is unknown. STUDY: A retrospective study was performed on consecutive patients initiating interferon therapy in the Hepatology clinic at a tertiary-care center between December 2004 and October 2007. All patients completed the Physicians Health Questionnaire (PHQ-9), a validated survey for major depressive disorder. Patients with a positive PHQ screen completed the Mood Disorders Questionnaire (MDQ), a validated screening tool for manic traits. Patients with a negative PHQ served as controls. All adverse psychiatric events were documented through retrospective record review for 6 months after interferon initiation. RESULTS: A total of 165 patients were treated with interferon α. One hundred thirty-two (80%) had a negative PHQ (controls) and 33 had a positive PHQ. Forty-one (30%) of the control patients had adverse psychiatric events. Psychiatric events occurred in 8 of 22 (36%) patients with positive PHQ but negative MDQ; 8 of 11 (73%) with positive PHQ and positive MDQ had psychiatric adverse events. This finding was statistically significant compared with the control group (P=0.007). The overall sustained viral response rate was 58% and was not statistically significant among groups. CONCLUSIONS: Baseline manic traits, as detected by the MDQ, were associated with high rates of adverse psychiatric events among individuals receiving antiviral therapy.

KW - bipolar disorder

KW - chronic hepatitis C

KW - depression

KW - interferon α therapy

UR - http://www.scopus.com/inward/record.url?scp=77955171502&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77955171502&partnerID=8YFLogxK

U2 - 10.1097/MCG.0b013e3181dc24f8

DO - 10.1097/MCG.0b013e3181dc24f8

M3 - Article

C2 - 20495465

AN - SCOPUS:77955171502

VL - 44

JO - Journal of Clinical Gastroenterology

JF - Journal of Clinical Gastroenterology

SN - 0192-0790

IS - 7

ER -