Implementing the International Committee on Mental Health in Cystic Fibrosis (ICMH) guidelines: Screening accuracy and referral-treatment pathways

Verkleij, Marieke; Winter, Derek de; Hurley, Margaret Anne; Abbott, Janice

doi:10.1016/j.jcf.2018.02.005

Cited by 28 publications

(34 citation statements)

References 21 publications

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“…This is not surprising as it was the main tool administered in the TIDES study, but was shown to underestimate depression and anxiety in CF 6 . Indeed, recent work indicates that there is much more psychopathology in people with CF and their parent caregivers than was estimated by the TIDES study 11 . In comparison with formal face-to face psychological assessment, the GAD-7 and PHQ-8/9 were able to identify all those with the most severe psychopathology and all those who endorsed the suicide ideation screening item.…”

Section: Discussionmentioning

confidence: 97%

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Mental Health screening in cystic fibrosis centres across Europe

Abbott

Havermans

Järvholm

et al. 2019

Journal of Cystic Fibrosis

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Objectives: The Cystic Fibrosis (CF) International Mental Health Guidelines Committee published consensus statements for screening and treating depression and anxiety in individuals with CF and their caregivers. This work aimed to evaluate the dissemination and implementation of the guidelines in Europe two years following their publication. Methods: A 28-item survey was developed by the multidisciplinary ECFS Mental Health Working Group and emailed to approximately 300 CF centres across Europe. The survey evaluated (a) who should be responsible for mental health (MH) care, (b) the current awareness and agreement of the guidelines, (c) the provision of recommended MH screening and follow-up care, and (d) successes, barriers and required resources/training needs. Results: Responses were received from 187 centres (28 countries represented). There was consensus that a psychologist should be responsible for MH care, although members of the multidisciplinary team (MDT) believed they should also share this responsibility. Sixty-two percent of respondents were aware of the guidelines; 82% percent fully, and 12% partially, agreed with them. Fifty percent (94 centres) had implemented screening. In the past year approximately 6000 patients and 2000 caregivers had been screened, with 80% of respondents using the recommended screening tools. Respondents reported 551 referrals for moderate/severe psychopathology and 84 urgent suicide ideation referrals. Conclusions: The challenges of different healthcare systems and language barriers are being overcome with a greater awareness of the importance of mental health among the MDT. MH screening is feasible and gaining momentum in both Western and Eastern Europe.

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Section: Discussionmentioning

confidence: 97%

“…For those reporting less severe difficulties on screening, agreement with formal assessment was less accurate. Typically, this was because people underestimated/underreported their symptoms at screening (with patients and caregivers requiring treatment referrals following psychological assessment) 11 .…”

Section: Discussionmentioning

confidence: 99%

Mental Health screening in cystic fibrosis centres across Europe

Abbott

Havermans

Järvholm

et al. 2019

Journal of Cystic Fibrosis

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“…The consequences of having a life-limiting chronic condition with a very high treatment and symptom burden result in challenges to well-being and has implications on the mental health of the person and their carers. 18,[137][138][139] Overall, there is a higher prevalence of anxiety and depression in adults with CF, and recent guidelines have indicated the need for mental health and well-being to be discussed openly and frequently with people with CF. 137 A regular screening process using short questionnaires has been instituted in many centers, with a follow-up plan to provide support for those with capital problems.…”

Section: Mental Health and Well-beingmentioning

confidence: 99%

“…137 A regular screening process using short questionnaires has been instituted in many centers, with a follow-up plan to provide support for those with capital problems. 139,140 Many people with CF find the CF team to be the main source of psychological support, but clear criteria for support from clinical psychology and/or psychiatry should be in place. 137 It is very important that mental health and wellbeing is acknowledged by CF MDTs as a key part of delivering CF care and that it is considered at all interactions.…”

Section: Mental Health and Well-beingmentioning

confidence: 99%

Adult Care in Cystic Fibrosis

Elborn

2019

Semin Respir Crit Care Med

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Cystic fibrosis (CF) is now more common in adults than children in countries with well-developed health care systems. The number of adults continues to increase and will further increase if the new cystic fibrosis transmembrane conductance regulator (CFTR) modulators are disease modifying. Most of the complex morbidity and almost all the mortality of CF occur in adults and will increasingly follow this pattern even with new effective modulator therapies. Maintaining good quality of life including social functioning and maximizing survival for adults are the key priorities. This requires a highly knowledgeable and adaptable multidisciplinary team, which, though focused on maintaining lung health, requires an increasing range of other disciplines and specialties to maximize well-being. Changes in health care systems will require current models of care to adapt to provide care for the large number of adult patients. With increasing survival and age, many are likely to have both CF morbidities and additional diseases of aging. New models are needed for health care delivery for this expanding population with complex medical conditions.

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“…Patients reported minimizing their responses on the screening forms and expressed concern for negative consequences. Use of formal clinical assessment revealed more accurate reporting of issues and allowed for reports of additional difficulties . Thus, the screening will identify significant mental health concerns, but further assessments may be necessary for less significant difficulties that can still affect care and quality of life (QoL).…”

Section: Patient‐reported Outcomes/prioritiesmentioning

confidence: 99%