Screening for symptoms of depression and anxiety in adolescents and young adults with cystic fibrosis.
BACKGROUND
Although studies have assessed symptoms of depression and anxiety in individuals with cystic fibrosis (CF), few have been conducted since the advent of new medical treatments (e.g., nebulized antibiotics, ThAIRpy Vest). Study objectives were to: (1) document symptoms of depression and anxiety for adolescents and young adults with CF and compare with normative values, (2) examine the associations among depressive/anxiety symptoms and gender, age, lung function, and body mass index, and (3) determine the relations between adolescent and caregiver symptoms of depression and anxiety.


METHODS
Patients and caregivers completed the Hospital Anxiety and Depression Scale (HADS) anytime (e.g., beginning or end) during routine CF clinic appointments.


RESULTS
Participants included 59 adolescents/young adults with CF (M(age)  = 15.8 years, 54% female, 98% Caucasian, M(FEV1% predicted)  = 84.6) and caregivers of 40 adolescents. Although symptom scores were in the normative range for patients with CF (M(Depression)  = 2.27 and M(Anxiety)  = 5.59), 3% and 32% exhibited clinically elevated symptoms of depression and anxiety, respectively. Symptoms of depression and anxiety were significantly associated with age (r = 0.28, 0.36). Symptoms of depression and anxiety were also positively correlated (r = 0.48). Females endorsed higher anxiety symptoms than males. While adolescent and caregiver anxiety scores were not related, higher caregiver depressive symptoms were associated with older patient age and worse lung function.


CONCLUSIONS
Data from the current study suggest low levels of depressive symptoms and substantial levels of anxiety symptoms in adolescents and young adults with CF. Consistent with prior literature, depressive symptoms appear higher in older patients and are significantly associated with anxiety symptoms. Caregiver symptomology appears to be more affected by an adolescent's health status, suggesting a need to screen caregivers when health begins to decline.
Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45229, USA. avani.modi@cchmc.org
Avani C
AC
Modi
Kimberly A
KA
Driscoll
Karen
K
Montag-Leifling
James D
JD
Acton
D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D017028:Caregivers / Q000523:psychology / Q000706:statistics & numerical data; D003550:Cystic Fibrosis / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D003863:Depression / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000523:psychology* / Q000706:statistics & numerical data*; D015995:Prevalence; D012129:Respiratory Function Tests; D055815:Young Adult
Pediatr Pulmonol. 2010 Aug;45(8):756-63
20597082
J Cyst Fibros. 2008 Nov;7(6):581-4
18692444
Pediatrics. 2009 Apr;123(4):e716-35
19336361
Am J Psychiatry. 2005 Feb;162(2):250-6
15677587
Acta Psychiatr Scand. 1983 Jun;67(6):361-70
6880820
J Cyst Fibros. 2008 Nov;7(6):495-500
18585104
J Am Acad Child Adolesc Psychiatry. 1991 Mar;30(2):290-7
2016234
Am J Epidemiol. 2001 Feb 15;153(4):345-52
11207152
Arch Gen Psychiatry. 2005 Jun;62(6):593-602
15939837
Semin Respir Crit Care Med. 2009 Oct;30(5):569-78
19760544
Br J Clin Psychol. 2001 Nov;40(4):429-34
11760618
J Abnorm Psychol. 2000 May;109(2):345-51
10895574
J Am Acad Child Adolesc Psychiatry. 1996 Dec;35(12):1575-83
8973063
J Affect Disord. 1999 Jan-Mar;52(1-3):11-7
10357013
Eur Child Adolesc Psychiatry. 2009 Feb;18(2):96-104
18807223
Chest. 2007 Jul;132(1):231-7
17625085
J Pediatr Psychol. 2003 Dec;28(8):535-45
14602844
J Dev Behav Pediatr. 1994 Feb;15(1):20-6
8195433
J Abnorm Psychol. 1991 May;100(2):214-22
2040773
Psychol Bull. 1992 Mar;111(2):244-55
1557475
Diabetes Care. 2007 Oct;30(10):2716-24
17644619
Curr Opin Pulm Med. 2008 Nov;14(6):582-8
18812836
Am J Psychiatry. 1993 Dec;150(12):1779-91
8238631
Thorax. 2006 Nov;61(11):969-74
16844728
Pediatr Pulmonol. 2009 Aug;44(8):784-92
19598276
Acta Paediatr. 2007 Jan;96(1):58-61
17187605
Am J Epidemiol. 1997 May 1;145(9):794-803
9143209
Pediatr Pulmonol. 2004 Nov;38(5):413-8
15470683
J Am Acad Child Adolesc Psychiatry. 1996 Mar;35(3):279-88
8714315
Am J Psychiatry. 2006 Jun;163(6):1001-8
16741200
Pediatrics. 1999 Dec;104(6):1274-80
10585977
J Anxiety Disord. 1997 Jul-Aug;11(4):377-94
9276783