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World J Gastroenterol. Nov 21, 2007; 13(43): 5736-5740
Published online Nov 21, 2007. doi: 10.3748/wjg.v13.i43.5736
Early prediction of major depression in chronic hepatitis C patients during peg-interferon α-2b treatment by assessment of vegetative-depressive symptoms after four weeks
Geert Robaeys, Jozef De Bie, Marieke C Wichers, Liesbeth Bruckers, Frederik Nevens, Peter Michielsen, Marc Van Ranst, Frank Buntinx
Geert Robaeys, Department of Gastroenterology and Hepatology, Ziekenhuis Oost Limburg, Genk, Belgium
Jozef De Bie, Department of Psychiatry, Ziekenhuis Oost Limburg, Genk, Belgium
Marieke C Wichers, Department of Psychiatry and Neuro-psychiatry, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University, Maastricht, The Netherlands
Liesbeth Bruckers, Center for Statistics, Limburgs Universitair Centrum, Diepenbeek, Belgium
Frederik Nevens, Department of Hepatology, Katholieke Universiteit Leuven, Leuven, Belgium
Peter Michielsen, Division of Gastroenterology and Hepatology, University Hospital, Antwerp, Belgium
Marc Van Ranst, Laboratory of Clinical and Epidemiological Virology, Department of Microbiology and Immunology, Rega Institute and University Hospitals, Katholieke Universiteit Leuven, Leuven, Belgium
Frank Buntinx, Department of General Practice, Katholieke Universiteit Leuven, Leuven, Belgium and Department of General Practice, Maastricht University, The Netherlands
Author contributions: All authors contributed equally to the work.
Supported by a received logistic support by Schering Plough
Correspondence to: Dr. Geert Robaeys, Ziekenhuis Oost Limburg, Department of Gastroenterology and Hepatology, Schiepse Bos 6, B 3600 Genk, Belgium. geert.robaeys@zol.be
Telephone: +32-89-326505 Fax: +32-89-327916
Received: March 19, 2007
Revised: August 25, 2007
Accepted: October 10, 2007
Published online: November 21, 2007

AIM: To study the predictive value of the vegetative-depressive symptoms of the Zung Depression Rating Scale for the occurrence of depression during treatment with peg-interferon α-2b of chronic hepatitis C (CHC) patients.

METHODS: The predictive value of vegetative-depressive symptoms at 4 wk of treatment for the occurrence of a subsequent diagnosis of major depressive disorder (MDD) was studied in CHC patients infected after substance use in a prospective, multi-center treatment trial in Belgium. The presence of vegetative-depressive symptoms was assessed using the Zung Scale before and 4 wk after the start of antiviral treatment.

RESULTS: Out of 49 eligible patients, 19 (39%) developed MDD. The area under the ROC curve of the vegetative Zung subscale was 0.73, P = 0.004. The sensitivity at a cut-point of > 15/35 was 95% (95% CI: 74-100). The positive predictive value equalled 44% (95% CI: 29-60).

CONCLUSION: In this group of Belgian CHC patients infected after substance use, antiviral treatment caused a considerable risk of depression. Seven vegetative-depressive symptoms of the Zung scale at wk 4 of treatment predicted 95% of all emerging depressions, at a price of 56% false positive test results.

Keywords: Interferons, Hepatitis C, Chronic, Substance-related disorders, Depression, Zung self rating scale, Prognosis