title: Associations between adherence, depressive symptoms and health-related quality of life in young adults with cystic fibrosis.
abstract: BACKGROUND
  Cystic fibrosis (CF) is a life shortening disease, however prognosis has improved and the adult population is growing. Most adults with cystic fibrosis live independent lives and balance the demands of work and family life with a significant treatment burden. The aim of this study was to examine the relationships among treatment adherence, symptoms of depression and health-related quality of life (HRQoL) in a population of young adults with CF.
  
  
  METHODS
  We administered three standardized questionnaires to 67 patients with CF aged 18-30 years; Morisky Medication Adherence Scale, Major Depression Inventory, and Cystic Fibrosis Questionnaire-Revised.
  
  
  RESULTS
  There was a response rate of 77 % and a majority of the young adults (84 %) were employed or in an education program. Most participants (74 %) reported low adherence to medications. One third (32.8 %) of the participants reported symptoms of depression. HRQoL scores were especially low on Vitality and Treatment Burden, and symptoms of depression were associated with low HRQoL scores (p < 0.01) with medium to large deficits across on all HRQoL domains (Cohen's d 0.60-1.72) except for the domain treatment burden. High depression symptom scores were associated with low adherence (r = -0.412, p < 0.001).
  
  
  CONCLUSIONS
  Despite improved physical health, many patients with CF report poor adherence, as well as impaired mental wellbeing and HRQoL. Thus, more attention to mental health issues is needed.
authors: The Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.
authors: K B
authors: 0000-0002-1776-5144
authors: KB
authors: Knudsen
authors: Cystic Fibrosis Center Copenhagen, Department of Pediatric and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors: T
authors: T
authors: Pressler
authors: The Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
authors: L H
authors: LH
authors: Mortensen
authors: The Department of Public Health, University of Copenhagen, Copenhagen, Denmark ; The University Hospital Center for Health Research (UCSF), Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors: M
authors: M
authors: Jarden
authors: Cystic Fibrosis Center Copenhagen, Department of Pediatric and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors: M
authors: M
authors: Skov
authors: Department of Psychology, University of Miami, Coral Gables, FL USA.
authors: A L
authors: AL
authors: Quittner
authors: The Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.
authors: T
authors: T
authors: Katzenstein
authors: Center of Adolescent Medicine, Department of Pediatric and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors: K A
authors: KA
authors: Boisen
keywords: Adherence; Cystic fibrosis; Depression; Mental health; Quality of life; Young adults