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Pegylated Interferon and Ribavirin-Induced Depression in Chronic Hepatitis C: Role of Personality
Objective: Pegylated interferon (PegIFN) and ribavirin (RBV) treatment for the hepatitis C virus (HCV) infection can induce depressive episodes. Personality traits have been associated with mood disorders. The aim of this study was to evaluate the personality profile as a risk factor for induced depression by PegIFN and RBV treatment in patients with HCV.
Method: In a prospective cohort study, 204 consecutive HCV outpatients who received PegIFN and RBV were assessed using the Structured Clinical Interview for DSM-IV Axis I Disorders and the Temperament and Character Inventory-Revised (TCI-R). Moreover, the Patient Health Questionnaire and the Hospital Anxiety and Depression Scale were administered at baseline and at 4, 12, 24, and/or 48 weeks of treatment. Patients were recruited between September 2003 and December 2006.
Results: One hundred eighteen patients (57.8%) were men. The mean (SD) age was 44.39 (10.4) years. The incidence of induced depression during the 48 weeks of antiviral treatment was 73 (42%). Low self-directedness dimension (HR = 0.63, 95% CI = 0.446 to 0.890, p =.009), baseline subclinical depression levels (HR = 1.113, 95% CI = 1.023 to 1.22, p =.013), and history of mood disorders (HR = 0.372, 95% CI = 0.220 to 0.629, p <.001) were independent predictive factors for induced depression during PegIFN and RBV treatment. Other predictive personality TCI-R subscales were enlightened second nature (HR = 2.939, 95% CI = 1.423 to 6.071, p =.004), fatigability (HR = 0.421, 95% CI = 0.237 to 0.749, p =.01), and disorderliness (HR = 0.449, 95% CI = 0.248 to 0.815, p =.008).
Conclusion: Low self-directedness, depressive symptoms at baseline, and history of previous mood disorders may predict induced depression by PegIFN and RBV in euthymic HCV patients.