Impact of COVID-19 on mental health: Effects on screening, care delivery, and people with cystic fibrosis

Abstract

Background Depression and anxiety are two to four times more prevalent in people with CF (pwCF) than the general population. COVID-19 may exacerbate mental health challenges, increasing demand for psychological services, while decreasing their availability. We assessed the impact of the pandemic on depression and anxiety in pwCF, including how COVID-19 affected the frequency of mental health screening and the types of services provided. Methods A 38‐item internet survey, completed in June 2020, assessed how COVID-19 affected: 1) the mental health clinician's role and screening processes; 2) barriers to screening and resource needs; 3) impact of COVID-19 on depression and anxiety, and 4) positive outcomes and confidence in sustaining mental health screening and treatment, including telehealth services, after the pandemic. Results Responses were obtained from 131 of the 289 US CF programs. Overall, 60% of programs (n=79) continued mental health screening and treatment, although less frequently; 50% provided individual tele-mental health interventions, and 9% provided telehealth group therapy. Clinically elevated depression symptoms (PHQ-9≥10; moderate to severe), were found in 12% of 785 pwCF, with 3.1% endorsing suicidal ideation. Similarly, elevated anxiety (moderate to severe; GAD-7≥10) was found in 13% of pwCF (n=779). Conclusions The COVID-19 pandemic created an opportunity to implement innovative solutions to disruptions in mental health screening and treatment in CF programs. We found that pwCF had increased access to psychological interventions during the pandemic via telehealth, supporting the continued integration of tele-mental health screening and treatment into CF care.

Stress and mental health in adolescents and young adults with cystic fibrosis 1 year after the COVID pandemic: Findings from an Italian sample

“…The top‐ranked concerns were: “afraid of being infected by the virus” and “extra alert for dangerous situations,” and “I cannot adhere to my usual routines.” Thus, anxiety and fear were the predominant psychological issues. Increased stress, negative thoughts, and trouble sleeping were also frequently reported 4,11 . PwCF reported disruptions in their daily routines, but they also spent more time on nebulized treatments and airway clearance.…”

“…Data from a survey completed in the United States in June 2020, showed moderate to severe depressive symptoms in 12% of 785 pwCF, with 3.1% endorsing suicidal ideation. Similarly, moderate‐severe anxiety was found in 13% of pwCF 11 . In a study conducted in United Kingdom 4 months after the pandemic started, clinically significant (mild–severe) anxiety rose from 27% pre‐COVID to 54% during COVID.…”

“…Increased stress, negative thoughts, and trouble sleeping were also frequently reported. 4,11 PwCF reported disruptions in their daily routines, but they also spent more time on nebulized treatments and airway clearance. Depression levels were low and stable, however, levels of anxiety rose significantly.…”

Short and Long-Term Impact of COVID-19 Infection on Previous Respiratory Diseases

“…Nevertheless, rapid changes were required in the healthcare systems 114 to prevent these patients from being exposed to the virus. Also, for this reason patients reduced their physical activity, 115 , 116 with the resulting muscular damage and increased anxiety-depression symptoms 117 , 118 , 119 that will lead to a need for future medical attention.…”

A year in review: Real world evidence, functional monitoring and emerging therapeutics in 2021

“…Furthermore, cardiovascular complications, obstructive sleep apnea, osteopenia and skeletal fragility are all emerging problems [51] , [52] , [53] , [54] , [55] . Addressing mental health issues and promoting emotional wellness warrant ongoing attention, particularly as those with depression are at increased risk of death [56] , [57] , [58] , [59] , [60] , [61] .…”