[Depression during interferon therapy in renal cell cancer patients--comparison with chronic hepatitis C patients].
[Depression during interferon therapy in renal cell cancer patients--comparison with chronic hepatitis C patients].
复制标题
肾细胞癌患者干扰素治疗期间抑郁情况——与慢性丙型肝炎患者的比较
DOI：
10.5980/jpnjurol1989.91.611
复制
发表时间：
2000
期刊：
影响因子：
--
通讯作者：
K. Mitamura
中科院分区：
文献类型：
--
作者：
H. Sakamoto;K. Inoue;M. Shimada;H. Yoshida;T. Otsubo;H. Miyaoka;K. Kamizima;M. Ishii;K. Mitamura
背景和目的
众所周知，抑郁症是干扰素治疗慢性活动性丙型肝炎患者的精神并发症之一。我们比较了肾癌患者和慢性活动性丙型肝炎患者在干扰素治疗过程中的精神状态。
方法
根据DSM-III-R和汉密尔顿抑郁量表(HDS)中的主要抑郁发作诊断标准，对40例肾癌患者在干扰素治疗前、治疗后2周、4周、12周和24周由精神科医生对其精神状态进行评估。用艾森克个性问卷(EPQ)在干扰素治疗前对85例丙型肝炎患者进行心理测评，并与85例丙型肝炎患者进行比较。
结果
40例患者中有8例在干扰素治疗前被诊断为抑郁症，其中5例在干扰素治疗2周后变得更加抑郁。9例患者在干扰素治疗后发现抑郁，其中7例在治疗4周前被确诊。所有患者均需接受治疗：停止干扰素治疗4例，减少干扰素治疗剂量8例，精神药物治疗13例。治疗前抑郁患者的神经质(EPQ)评分明显高于未抑郁患者。两组患者在年龄、性别、癌症分期等方面均无差异。肾癌患者抑郁的发生率与接受干扰素治疗的丙型肝炎患者相同。但肾癌患者的抑郁状态比丙型肝炎患者更早被诊断出来，而且更严重。
结论
泌尿科医生应该意识到接受干扰素治疗的肾癌患者的精神症状，就像肝炎患者一样。肾癌患者的抑郁被认为与癌症本身有关，这可能解释了与丙型肝炎患者相比，其严重程度更高的原因。
BACKGROUND AND PURPOSE
Depression is well known as one of the psychiatric complications of interferon (IFN) therapy in patients with chronic active hepatitis C. We compared the psychiatric status during interferon therapy between patients with renal cell cancer (RCC) and those with chronic active hepatitis C.
METHODS
The psychiatric status of 40 patients with renal cell cancer, 36 who were subjected to radical nephrectomy and 4 who were not because of the presence of distant metastasis and other complicated underlying diseases, was assessed by psychiatrists before and at 2, 4, 12 and 24 weeks after the start of IFN therapy according to the major depressive episode diagnostic criteria listed in the DSM-III-R and the Hamilton Depression Scale (HDS). The mental aspect was measured using the Eysenk Personality Questionnaire (EPQ) before IFN therapy, and the results were compared with those obtained in 85 hepatitis C patients evaluated according to the same protocol for psychiatric assessment.
RESULTS
Eight of the 40 patients were diagnosed as having depression before IFN therapy and 5 of them became even more depressed 2 weeks after the start of IFN therapy. Nine patients were found to be depressed after the start of IFN therapy, 7 of them were diagnosed before 4 weeks of therapy. All the patients needed treatment for depression: discontinuation of IFN therapy in 4, decrement of the IFN dose in 8, and psychiatric drug medication in 13. The patients who suffered from depression had significantly higher scores in neuroticism (EPQ) before IFN therapy than those who did not become depressed. There was no difference in age, sex or cancer stage between the two groups. The occurrence of depression in RCC patients was the same as that observed in hepatitis C patients receiving IFN therapy. But in RCC patients the depressive state was diagnosed earlier and was more severe than that observed in hepatitis C patients.
CONCLUSION
Urologists should be aware of the psychiatric symptoms of RCC patients under IFN therapy just as in hepatitis patients. The depression in RCC patients was considered to be related to the cancerous disease itself which may explain its higher degree of severity, as compared to hepatitis C patients.