It is well known that interferon alpha (IFN-a) therapy given to patients with HCV and canceris associated with the development of depression and anxiety. However, the strength of association is often questioned among different studies. Aim of the study is to determine the prevalence of depression and anxiety in chronic hepatitis C patients receiving pegylated interferon alpha (PegIFN) and ribavirin (RBV) therapy and to detect the possible risk factors for development of these adverse events. A total of 100 chronic HCV patients eligible for interferon therapy from the hepatitis outpatient clinic of Assiut University Hospital were included. Full medical assessment was done before initiation of the treatment. Assessment of the psychiatric history and examination by using (DSM-IV), structured interview for the five factor model of personality and psychiatric questionnaires using Hamilton depression (HD) and Hamilton anxiety (HA) scores to assess the severity of depression and anxiety were done. Both medical and psychiatric assessment was done at the start of the study and after starting the treatment at 2 months, 4 months and 6 months. At initiation of the study all patients had normal HA and HD scores. Depression developed in 69 %, 60.2% and 60.2% after 2 months, 4 months and 6 months of IFN therapy, respectively. While about 9%, 8.6% and 6.9% developed anxiety after2, 4 and 6 months of treatment, respectively. Most of the patients developed mild to moderate depression. No case developed moderate or severe anxiety. Most of these cases developed manifestations after 2 months of starting the treatment, 69% developed depression and 9% developed anxiety. There was a correlation between depression and anxiety during IFN treatment (p= 0.000). Other risk factors to develop these side effects included smoking, neuroticism and patients concerns as regard development of other side effects that decrease quality of life, treatment duration and failure of response and rumors of new drugs such as DAAs. IFN - induced depression and anxiety in chronic HCV patients are common. These are considered side effects of the drug and not direct effect of the virus. Patient's personality and other patients concerns regarding treatment are considered the main risk factors in our study.

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