Symptoms of depression impact the course of lung function in adolescents and adults with cystic fibrosis

Abstract

BackgroundEpidemiological studies report high rates of depression among patients with cystic fibrosis (CF). Assuming a causal relationship between depression and the progression of CF, our hypothesis is that elevated symptoms of depression would be a predictor of worse lung function after two years.MethodsIn the context of the TIDES study, 473 German patients with CF (age 12–53 years, FEV1% predicted M = 66.2, range 13–137) completed the Hospital Anxiety and Depression Scale (HADS). Lung function (FEV1% predicted) was assessed at baseline and followed up two years later. Repeated measures analysis was performed involving the level of FEV1% and the level of depressive symptoms at baseline as independent factors and FEV1% at the 2-year follow-up as the dependent variable.ResultsInteraction between lung function and depression at baseline significantly affected the change in lung function at the 2-years observation interval. The largest decline in FEV1% occurred in depressed patients with good lung function at baseline. In contrast, patients without any clinically relevant depressive symptoms and with poor lung function at baseline showed a slight increase two years later.ConclusionThe findings emphasise the need to screen patients with CF for symptoms of depression and to treat co-morbid depression.

Factors Affecting Prognosis and Prediction of Outcome in Cystic Fibrosis Lung Disease

“…This is highly important and there is an association between depression and lower FEV1 [146]. Also, patients with well-preserved spirometry who have depression demonstrate more significant decline in lung function than those with no depressive symptoms [148]. Depression is associated with negative medication beliefs leading to lower medication adherence, which ultimately may lead to poorer prognosis, hence it is important to evaluate patients holistically beyond the medical complications of CF when assessing prognosis [149].…”

Evaluation of selected insomnia predictors in adolescents and young adults with cystic fibrosis

“…The study was conducted among 95 cystic fibrosis patients aged [14][15][16][17][18][19][20][21][22][23][24][25] The study involved patients who had agreed to participate voluntarily (the legal guardian's consent was also obtained for patients under 18 years of age). The study excluded patients after lung transplantation, those with diagnosed mental illness, in the terminal state, and with clinical worsening (aggravation of dyspnoea and cough, coughing up sputum, the use of assisted breathing or respirotherapy) in the 4 weeks prior to enrolment, or those who had had traumatic experiences in the last 6 months (e.g.…”

“…The incidence of negative emotional states in patients with CF is unlikely to differ from that in the general population [14][15][16] ; however, due to connotations with other variables negatively affecting health (e.g. respira-tory efficiency, pain) they are significant determinants of survival in CF patients [17][18][19] and should be assessed on a regular basis. The pursuit of knowledge and understanding of the mutual relationships between variables, as well as the extension of research in this area can significantly improve the detection of negative factors and optimize the quality of medical care, with the consequent better emotional and physical condition of patients.…”

Effectiveness and cost-effectiveness of guided Internet- and mobile-based CBT for adolescents and young adults with chronic somatic conditions and comorbid depression and anxiety symptoms (youthCOACHCD): study protocol for a multicentre randomized controlled trial

“…Mental disturbances and disorders are common in this population, particularly depression-and anxiety-related symptoms [8,9], which in turn are associated with reduced quality of life, reduced treatment adherence, poorer long-term prognosis [10], and increased health service use (outpatient and inpatient, medical/medical claims, and pharmacy claims) [11].…”