Baseline mood and psychosocial characteristics of patients developing depressive symptoms during interleukin-2 and/or interferon-alpha cancer therapy.
Brain, Behavior, and Immunity. 2004-05-01; 18(3): 205-213
DOI: 10.1016/j.bbi.2003.11.004
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1. Brain Behav Immun. 2004 May;18(3):205-13.
Baseline mood and psychosocial characteristics of patients developing depressive
symptoms during interleukin-2 and/or interferon-alpha cancer therapy.
Capuron L(1), Ravaud A, Miller AH, Dantzer R.
Author information:
(1)Department of Psychiatry and Behavioral Sciences, Emory University School of
Medicine, Atlanta, GA 30322, USA.
It has been suggested that patients with subclinical mood symptoms prior to
initiating cytokine treatment (as revealed by elevated baseline scores on
depression rating scales) are more likely to become clinically depressed during
the course of cytokine therapy. The present study was designed to identify which
specific preexisting symptoms predict development of depressive symptomatology
during treatment with the cytokines, interleukin-2 (IL-2) and/or interferon-alpha
(IFN-alpha), in patients with cancer. Thirty-two patients with renal cell
carcinoma or malignant melanoma eligible to receive treatment with IL-2 and/or
IFN-alpha were enrolled in the study. At baseline and after one month of cytokine
therapy (endpoint), depressive symptoms were assessed using the
clinician-administered Montgomery-Asberg depression rating scale (MADRS).
Illness-related coping strategies, social support, somatic complaints, quality of
sleep and demographic factors were also assessed as relevant baseline predictive
factors. MADRS scores significantly increased during cytokine therapy. Patients
with moderate to marked depressive symptomatology at study endpoint exhibited
higher baseline scores in dimensions of the MADRS scale assessing emotional
(especially reported sadness), cognitive (especially pessimistic thoughts) and
neurovegetative (sleep disturbances) symptoms compared to patients who remained
free of depressive symptoms during cytokine therapy. Interestingly, only
emotional symptoms and sleep disturbance at baseline, along with low social
support, predicted severity of depressive symptoms at the end of the first month
of therapy. By documenting specific behavioral vulnerability factors for
cytokine-induced depressive symptoms, these findings may help identify patients
at risk for mood disturbances during cytokine treatment and help target specific
patient populations and specific symptoms for preventative strategies.
DOI: 10.1016/j.bbi.2003.11.004
PMID: 15050647 [Indexed for MEDLINE]