title: Anxiety and depression in adults with cystic fibrosis: a comparison between patients and the general population in Sweden and three other European countries.
abstract: BACKGROUND
  Cystic fibrosis (CF) is the most common autosomal recessive life-shortening disease among Caucasians. Studies exploring the prevalence of anxiety and depression in adult CF patients are few, show inconsistent findings and rarely include comparisons with general populations. Prevalence and degree of anxiety and depression were investigated in adult CF patients in Sweden, Belgium, Germany and the UK, and compared to corresponding general population data.
  
  
  METHODS
  Adult non-transplanted CF patients from the three largest CF-centres (out of four) in Sweden (N = 129; Age range 18-70 years; 50 % women) completed the Hospital Anxiety and Depression Scale (HADS). Studies using HADS in adult CF populations in the UK, Germany, and Belgium were included, as well as HADS normative data from the corresponding general populations.
  
  
  RESULTS
  No elevated risk for anxiety and depression was found among the CF patients. However, a Country x Group interaction effect emerged; CF patients experienced a higher degree of anxiety than the general population in Sweden, but not in the other countries, though this finding did not remain significant in a logistic regression analysis. In Sweden the effect was limited to women. A Country x Group interaction effect was also found for Depression; CF patients experienced lower degree of depression than the general population in Sweden, Germany and the UK, but not in Belgium/Netherlands.
  
  
  CONCLUSIONS
  Contrary to earlier outcomes, the present results do not indicate any general elevated risk for anxiety and depression among CF patients. Anxiety was slightly higher in the Swedish CF population, compared to the general population; this finding was not seen in the other countries. Depression among CF patients was lower than or similar to that in the general populations in the studied countries.
authors.affiliation: Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Nobels väg 9, S-171 65, Solna, Sweden. lena.backstrom.eriksson@ki.se.|Karolinska University Hospital, Stockholm CF-center, Stockholm, S-141 86, Sweden. lena.backstrom.eriksson@ki.se.
authors.forename: Lena
authors.initials: L
authors.lastname: Backström-Eriksson
authors.affiliation: Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Nobels väg 9, S-171 65, Solna, Sweden. kimmo.sorjonen@ki.se.
authors.forename: Kimmo
authors.initials: K
authors.lastname: Sorjonen
authors.affiliation: Karolinska University Hospital, Stockholm CF-center, Stockholm, S-141 86, Sweden. agneta.bergsten@info.se.
authors.forename: Agneta
authors.initials: A
authors.lastname: Bergsten-Brucefors
authors.affiliation: Karolinska University Hospital, Stockholm CF-center, Stockholm, S-141 86, Sweden. lena.hjelte@ki.se.|Department of Clinical Science, Intervention and Technology, Division of Pediatrics, Karolinska Institutet, S-141 86, Stockholm, Sweden. lena.hjelte@ki.se.
authors.forename: Lena
authors.initials: L
authors.lastname: Hjelte
authors.affiliation: Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Nobels väg 9, S-171 65, Solna, Sweden. bo.melin@ki.se.
authors.forename: Bo
authors.initials: B
authors.lastname: Melin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology* / Q000523:psychology; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000523:psychology; D001530:Belgium / Q000453:epidemiology; D016022:Case-Control Studies; D003550:Cystic Fibrosis / Q000453:epidemiology* / Q000523:psychology; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult