Depression during interferon therapy for chronic viral hepatitis: early identification of patients at risk by means of a computerized test

Objectives At the doses used for the treatment of chronic viral hepatitis, interferon (IFN)-related side-effects are usually modest, even though in so me cases they require the interruption of therapy. Neuropsychiatric disturb ances that range from modest depression and irritability to forms of manic- depressive psychosis and attempted or successful suicides are among the mos t important side-effects. The aim of our study was to determine whether the Minnesota Multiphasic Personality Inventory (MMPI) is a sensitive and reli able test for the early identification of patients at risk of depression be fore IFN therapy is commenced, and whether it could be useful for the monit oring of these patients during treatment. Methods We prospectively studied 67 patients with chronic active liver dise ases, consecutively enrolled in open studies and treated with r-IFN alpha 2 . Before starting therapy and after 3 months of treatment, all patients und erwent a clinical neurological evaluation and MMPI. Results At baseline, the correlation between the clinical evaluation and th e score of the depression scale of the MMPI was statistically significant ( P < 0.0001). Nine of 14 (64.3%) patients with a baseline score greater than or equal to 60/100 showed a depressive mood after 3 months of therapy. Fiv e of 44 patients (11.3%) with a baseline score < 60/100 showed a depression of medium level after 3 months of treatment. This difference was highly si gnificant (P < 0.0001). Conclusions According to our results, the MMPI is a reliable and sensitive test for the early identification of patients at risk of depression before and during IFN therapy for chronic viral liver diseases. (C) 2000 Lippincot t Williams & Wilkins.