Psychiatric symptoms related to interferon therapy for chronic hepatitis C: Clinical features and prognosis
Psychiatric symptoms related to interferon therapy for chronic hepatitis C: Clinical features and prognosis
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DOI：
10.1046/j.1440-1819.2000.00754.x
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发表时间：
2000-10-01
影响因子：
11.9
通讯作者：
Kumada, H
中科院分区：
文献类型：
--
作者：
Hosoda, S;Takimura, H;Kumada, H
干扰素治疗病毒性肝炎期间的精神症状一直是会诊联络精神病学中的一个关键问题。然而，很少有研究精神管理这些症状及其预后。在1991年至1995年接受干扰素治疗的943例慢性丙型肝炎患者中，43例（4.6%）患者在干扰素治疗期间出现精神症状。3例（0.3%）既存精神疾病患者出现症状加重，被排除在研究之外。所有三名患者都能够完成干扰素治疗与精神管理。40例（4.2%）患者出现IFN所致的精神症状。13例患者（1.4%）被诊断为焦虑障碍，21例患者（2.2%）表现为伴有抑郁特征的心境障碍。6例患者（0.6%）有其他精神疾病，包括4例患者（0.4%）的精神病性障碍伴妄想/幻觉，1例患者（0.1%）的心境障碍伴躁狂特征，1例患者（0.1%）的谵妄。妇女出现精神症状的次数明显多于男子。40例患者中有10例（25%）因IFN引起的精神症状而停止IFN治疗。12例患者（30%）在停用IFN后需要精神科治疗超过24周，7例患者在本研究结束时仍有焦虑、失眠和轻度心境减退。统计分析显示，IFN-β治疗和精神病性症状，包括精神病性症状，谵妄和躁狂症状的精神症状显着相关的长期精神问题。有相当数量的患者需要长期的精神管理，即使在停止干扰素治疗。
Psychiatric symptoms during interferon (IFN) therapy for viral hepatitis have been a crucial problem in consultation-liaison psychiatry. However, there have been few studies on psychiatric management for these symptoms and their prognosis. Among 943 patients who were treated with IFN for chronic hepatitis C between 1991 and 1995, 43 patients (4.6%) developed psychiatric symptoms during IFN treatment. Three patients (0.3%), with pre-existing psychiatric disorders showed aggravated symptoms and were excluded from the study. All three patients were able to finish the IFN therapy with psychiatric management. Forty patients (4.2%) manifested psychiatric symptoms induced by IFN. Thirteen patients (1.4%) were diagnosed as anxiety disorder and 21 patients (2.2%) revealed mood disorder with depressive features. There were other psychiatric disorders in six patients (0.6%), including psychotic disorder with delusions/hallucinations in four patients (0.4%), mood disorder with manic features in one patient (0.1%) and delirium in one patient (0.1%). Women developed psychiatric symptoms significantly more than men. Ten of 40 patients (25%) stopped IFN treatment because of manifesting psychiatric symptoms induced by IFN. Twelve patients (30%) required psychiatric treatment for more than 24 weeks after ceasing IFN, and seven patients still had anxiety, insomnia and mild hypothymia at the end of the present study. Statistical analysis revealed that IFN-beta therapy and psychiatric manifestations including psychotic symptoms, delirium and manic symptoms were significantly related to long-term psychiatric problems. There are considerable numbers of patients who have required long-term psychiatric management even after cessation of IFN treatment.