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Comparative Study
. 2021 Sep 1:292:766-772.
doi: 10.1016/j.jad.2021.05.087. Epub 2021 Jun 23.

Influence of gender on cytokine induced depression and treatment: Gender aspects of IFN-α-induced depression

Susanne Sarkar  1 , Jonas Kemper  2 , Rahul Sarkar  3 , Loni Brants  4 , Astrid Friebe  5 , Ulrich Spengler  6 , Thomas Schläpfer  7 , Jens Reimer  8 , Peter Buggisch  9 , Johann Ockenga  10 , Ralph Link  11 , Michael Rentrop  12 , Hans Weidenbach  13 , Gwendolyn Fromm  14 , Klaus Lieb  15 , Thomas F Baumert  16 , Thomas Discher  17 , Stefan Zeuzem  18 , Thomas Berg  19 , Martin Schaefer  20
Affiliations
Comparative Study

Influence of gender on cytokine induced depression and treatment: Gender aspects of IFN-α-induced depression

Susanne Sarkar et al. J Affect Disord. .

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.

Keywords: Antidepressant therapy; Cytokine treatment; Depression; Gender; Inflammation; Interferon-alpha.

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