Introduction
Cystic fibrosis (CF) is the most common autosomal recessive disease that
leads to early mortality in Caucasians worldwide 1.
The disease is highly burdensome with progressive multisystem
involvement, mostly problematic due to persistent lung infections,
frequent hospitalizations and time consuming treatment regimens taking 2
to 4 hours per day in average 1; 2. Numerous studies
indicate that children and adults with chronic illnesses, as well as
parent caregivers, are at increased risk for psychological difficulties
.
The largest psychological screening study conducted on CF, The
International Depression Epidemiological Study (TIDES), shows that rates
of depression among patients are two times and parents of children with
CF are 2-3 times higher than rates of depression in broad community
samples 4. Psychological distress in individuals with
CF has been associated with: worse health outcomes (e.g., decreased lung
function, lower BMI), worse adherence, worse quality of life, increased
exacerbations, hospitalizations, and health-care costs5-8. With these facts, The International Committee on
Mental Health in Cystic Fibrosis (ICMH) developed consensus statements
for screening and treating depression and anxiety in individuals with CF
and their caregivers. The CF Foundation and European Cystic Fibrosis
Society (ECFC) recommend 9-item Patient Health Questionnaire Depression
Scale (PHQ-9) and 7-Item Generalized Anxiety Disorder Scale (GAD-7) for
screening 9.
Despite evidence in the TIDES study that a new diagnosis of CF-related
diabetes, and events such as hemoptysis and pneumothorax, may precede
elevations in symptoms of depression and anxiety, little is also known
about the ‘triggers’ of psychological symptoms, or how mood affects
health outcomes in this complex disease. Therefore, ICMH suggested
further studies to identify psychosocial and clinical risk factors of
depression and anxiety in CF patients and their caregivers9.
In the present study, we aimed to assess the prevalence of depression
and anxiety in CF patients and parent caregivers along with identifying
possible risk factors.