ABSTRACT
Objective: Depression has been associated with hepatitis C, as well as with its treatment with proinflammatory cytokines (i.e., interferon). The new direct-acting antiviral agents (DAAs) have minimal adverse effects and high potency, with a direct inhibitory effect on non-structural viral proteins. We studied the incidence and associated factors of depression in a real-life prospective cohort of chronic hepatitis C patients treated with the new DAAs. Methods: The sample was recruited from a cohort of 91 patients with hepatitis C, of both sexes, with advanced level of fibrosis and no HIV coinfection, consecutively enrolled during a 6-month period for DAA treatment; those euthymic at baseline (n=54) were selected. All were evaluated through the depression module of the Patient Health Questionnaire (PHQ-9-DSM-IV), at three time points: baseline, 4 weeks, and end-of-treatment. Results: The cumulative incidence (95%CI) of major depression and any depressive disorder during DAA treatment was 13% (6.4-24.4) and 46.3% (33.7-59.4), respectively. No differences were observed between those patients with and without cirrhosis or ribavirin treatment (p > 0.05). Risk factors for incident major depression during DAA treatment included family depression (relative risk 9.1 [1.62-51.1]), substance use disorder (11.0 [1.7-73.5]), and baseline PHQ-9 score (2.1 [1.1-3.1]). Conclusions: The findings of this study highlight the importance of screening for new depression among patients receiving new DAAs, and identify potential associated risk factors.
Subject(s)
Humans , Male , Female , Adult , Aged , Antiviral Agents/therapeutic use , Hepatitis C/psychology , Hepatitis C/drug therapy , Depressive Disorder/epidemiology , Psychiatric Status Rating Scales , Ribavirin/therapeutic use , Spain/epidemiology , Time Factors , Logistic Models , Incidence , Prospective Studies , Risk Factors , Treatment Outcome , Hepatitis C/epidemiology , Middle AgedABSTRACT
El estudio está basado en 39 casos de pacientes diagnosticados con neumonía y tratados según el método establecido por Samuel Hahnemann en el Organon. Observa los medicamentos más frecuentemente indicados, teniendo en cuenta la repertorización individual de los síntomas de cada paciente en el cuadro agudo. Hace un estudio comparativo sobre la evolución de los pacientes en función de las potencias utilizadas (30CH y 6LM) y de la conveniencia, o no, de la continuidad del tratamiento hasta la ausencia total de los síntomas clínicos.
This study is grounded on 39 cases of patients with pneumonia, who have been treated according to the method established by Samuel Hahnemann in the Organon. I pointed to the most frequently indicated remedies to treat this condition, following the individual repertorization of the symptoms of each patient. I compared also the evolution of the cases depending of the use of 30CH or 6LM potencies. I also questioned the suitability of continuing the treatment once the clinical symptoms have vanished.