SUICIDAL IMPULSES IN PATIENTS WITH CHRONI C VIRAL-HEPATITIS-C TREATEDBY ALPHA-INTERFERON

We report 5 cases of psychiatric side effects in patients treated with alpha interferon for chronic viral C hepatitis. The first case includ es depression with suicidal impulses without a suicide attempt; there was a positive rechallenge of interferon. In the second and third case s, depression occurred during interferon therapy, but has not disappea red after interferon withdrawal. In the 4(th) and 5(th) cases, depress ion occurred after interferon withdrawal. Overall, suicide was attempt ed in 4 cases after interferon withdrawal and was responsible for 2 de aths. The prevalence of suicide attempts during the 6 to 12 months of interferon therapy was 0% compared to 1.3% during the 6 months after i nterferon therapy (P < 0.05) in 306 patients with chronic hepatitis C treated by interferon in our local area network during the same period . In conclusion: a) depression does not always disappear after interfe ron is discontinued; b) regular psychiatric follow-up is justified dur ing treatment with interferon; c) psychiatric supervision should be co ntinued, even more frequently after interferon withdrawal; d) the incr eased risk of psychiatric side-effects due to interferon as well as th eir severity suggest interferon should be administered with caution; e ) the role of interferon can only be evaluated in controlled studies i ncluding the incidence and predictive value of emotional disorders.