Approximately 170 million people worldwide suffer from chronic hepatitis C. Depression is more prevalent among people with chronic viral hepatitis C as compared to the normal population; it can be identified in about 58% of patients. Based on the literature, the authors review the aetiology of depression occurring in hepatic disease, with regard to the neuropathogenic activity of hepatitis C virus (HCV). They report research results that may serve as evidence for alterations caused by the hepatitis C virus in the central nervous system. Depression is one of the side effects of interferon-α used for treating HCV infection. The authors discuss the biologic bases, the development and the consequences of depression caused by interferon in chronic hepatitis C, and they review the course of assessing patients with depression. They summarise the steps of psychiatric pharmacotherapy in chronic liver diseases. It is important to consider, whether a patient with chronic hepatitis C and depression can be treated with interferon. Missing interferon therapy may lead to a fatal outcome of the hepatic disease. In order to come to a prudent decision an appropriate cooperation is needed between physician and psychiatrist.
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