[Psychiatric symptoms related to interferon treatment for chronic hepatitis]

Psychiatric symptoms related to interferon (IFN) treatment for chronic hepatitis have been a crucial issue in consultation liaison psychiatry. In this report we present a hypothesis regarding the development of psychiatric symptoms. There were marked differences in the incidence of psychiatric symptoms among studies. This may be because psychiatric symptoms are readily overlooked in routine practice in the Department of Internal Medicine, and because IFN treatment frequently causes transient depression. It was speculated that psychiatric intervention was required in 10-19% of the patients. We found that among psychiatric symptoms related to IFN treatment, depression with irritation and anxiety was commonly observed. In many case reports, mood disorder was noted as a precursory or residual symptom of delirium and hallucination/delusion. We present management guidelines for psychiatric symptoms in IFN treatment, and propose that self-assessment scaling should be performed before and during treatment to detect psychiatric symptoms in the early stage, and that patients with suspected symptoms should be promptly referred to the Department of Psychiatry. We introduce an open study of antidepressant treatment for depression related to IFN treatment, and recommend aggressive administration of antidepressants. IFN treatment should be discontinued in patients with: moderate or severe suicidal ideation or suicide attempt, depression that does not respond to antidepressant treatment, manic state, hallucination/delusion, or delirium.