Psychiatria pre prax 6/2008

CHRONIC HEPATITIS C AND DEPRESSION – REDOUBTABLE COMBINATION?

Chronic hepatitis C (CHC) is a major cause of chronic liver diseases including liver cirrhosis and hepatocellular carcinoma. Actual standard treatment of CHC consists of combination antiviral therapy with pegylated interferon alfa and ribavirin. Clinical research has shown that many interferon-associated psychiatric adverse effects are treatable but need sonsequent and early intervention. Modern antidepressants, especially SSRIs (selective serotonin reuptake inhibitors), are the most important tool for treating or preventing depression during antiviral treatment of CHC. The most effective psychotherapeutic treatment options for patients experiencing depressive symptoms during HCV therapy are psychoeducational programs, supportive treatment and behavioral or cognitive therapy. Psychiatric comorbidity among patients with CHC is not an absolute contraindication of treatment of CHC but carefully monitoring of depression and other psychiatric disorders is necessary. Interdisciplinary approaches should be offered to reduce and manage psychiatric adverse events and thereby increase the efficacy of interferon-based therapy for chronic hepatitis C.

Keywords: chronic hepatitis, depression, monitoring of depression – depression scales, antidepressants, interdisciplinary team for treatment of patients with CHC.