Temperament and character profile as risk factor of depression and anxiety syndromes induced by interferon and ribavirin treatment in chronic hepatitis c patients

Background:The aim of this study was to examine the temperament and character profile as risk factors of interferon and ribavirin (IFN+RBV) induced psychopathology in chronic hepatitis C patients. According to the Cloninger's biosocial model (TCI), the temperament dimension harm avoidance (HA) is suggested to indicate central serotonergic turnover, which is further correlated with depressive/anxiety states.Methods:198 patients with chronic hepatitis C in treatment with IFN+RBV were evaluated at baseline and 4, 12 and 24 weeks of treatment. All subjects were assessed by the Patient Health Questionnaire (PHQ), the Hospital Scale of Anxiety and Depression (HADS) and the Temperament and Character Inventory-revised (TCI-R) questionnaire (at basal level).Results:At baseline, 32 patients had a psychiatric syndrome (16.1%). During the first six months of IFN+RBV treatment the incidence of depression/anxiety syndromes was 37.9% (n=63/166). The personality factors associated (p<0.001, corrected) were: HA dimension; fatigability subscale (HA4), anticipatory worry subscale (HA1); self-directedness dimension (SD); congruent subscale (SD5); and; social acceptance subscale (C1). By logistic regression analysis the independent variables that most predict the induced cases (PHQ+) (dependent variable) were: previous history of mood disorder (p<0.001; Exp(b)=5.655), and both HA4 (p<0.001; Exp(b)=1,104) and C1 (p<0.001; Exp(b)=0.845) subscales.Conclusion:The assessment of personality traits (HA, C) and previous history of psychiatric disorders before start the IFN+RBV treatment in chronic hepatitis C patients might identify the patients at risk of induced depression/anxiety disorders during the treatment.This study has been done in part with grants: Instituto-Carlos III (G03/02) (Red-Hepatologia) and (GO3/184) (Red-Genotipacion/Psiquiatria Genetica).