1. Influence of gender on cytokine induced depression and treatment
- Author
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Susanne Sarkar, Jonas Kemper, Hans Weidenbach, Thomas Berg, Michael Rentrop, Astrid Friebe, Ulrich Spengler, Loni Brants, Martin Schaefer, Thomas Discher, Johann Ockenga, Peter Buggisch, Klaus Lieb, Ralph Link, Rahul Sarkar, Thomas Schläpfer, Jens Reimer, Gwendolyn Fromm, Stefan Zeuzem, and Thomas F. Baumert
- Subjects
medicine.medical_specialty ,Hamilton Anxiety Rating Scale ,business.industry ,Alpha interferon ,medicine.disease ,Placebo ,030227 psychiatry ,03 medical and health sciences ,Psychiatry and Mental health ,Clinical Psychology ,0302 clinical medicine ,Rating scale ,Internal medicine ,medicine ,Major depressive disorder ,Antidepressant ,Escitalopram ,business ,030217 neurology & neurosurgery ,Depression (differential diagnoses) ,medicine.drug - Abstract
Background Cytokine treatment with Interferon-alpha (IFN-α) represents a clinical model of immune associated depression, but it remains unclear if it is of the same entity as major depressive disorder (MDD). The study focuses on possible gender differences in IFN-α induced depression and effects of a pre-emptive antidepressant treatment. Methods Data from 181 patients with chronic hepatitis C infection (cHC) without history of mental illnesses undergoing treatment with IFN-α 2a and ribavirin were re-analyzed for gender effects. Patients with a pre-emptive antidepressant therapy with Escitalopram (n = 90, verum group) to prevent IFN-induced depression were compared to patients who received placebo (n = 91). Depressive symptoms before and during HCV-treatment were assessed using the Montgomery–Asberg Depression Rating Scale (MADRS), Beck's Depression Inventory (BDI) and the Hamilton Anxiety Rating Scale. Results We found significant differences regarding the incidence and severity of depressive symptoms between men and women for patients without antidepressant pre-treatment (placebo group). Significantly more women without pre-emptive antidepressant therapy suffered from clinically relevant depression (MADRS values ≥ 13, p = 0.041) and self-rated depressive symptoms (BDI ≥ 17, p = 0.024). Antidepressant pre-treatment showed comparable effects regarding the reduction of incidence and severity of depression in both women and men. Conclusions Compared to MDD, IFN-alpha-induced depression in patients with cHC is also characterized by gender differences with an increased risk for women but no gender difference regarding the effects of an antidepressant pre-treatment is found. Our data strengthens the hypothesis that Interferon-induced depression serves as a clinical model for immune related depressive disorders.
- Published
- 2021
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