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Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries
  1. Alexandra L Quittner1,
  2. Lutz Goldbeck2,
  3. Janice Abbott3,
  4. Alistair Duff4,
  5. Patrick Lambrecht5,
  6. Amparo Solé6,
  7. Marijke M Tibosch7,
  8. Agneta Bergsten Brucefors8,
  9. Hasan Yüksel9,
  10. Paola Catastini10,
  11. Laura Blackwell11,
  12. Dave Barker12
  1. 1Department of Psychology & Pediatrics, University of Miami, Coral Gables, Florida, USA
  2. 2Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Ulm, Germany
  3. 3School of Psychology, University of Central Lancashire, Preston, UK
  4. 4The Regional Paediatric CF Unit, Leeds Teaching Hospitals NHS Trust, Leeds, Yorkshire, UK
  5. 5Department of Clinical and Lifespan Psychology, Free University Brussels, Brussels, Belgium
  6. 6Adult CF and Lung Transplant Unit, University Hospital la Fe, Valencia, Spain
  7. 7Department of Medical Psychology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
  8. 8Stockholm CF Centre, Karolinska University Hospital Huddinge, Karolinska institute, Stockholm, Sweden
  9. 9Medical Faculty, Department of Pediatric Allergy and Pulmonology, Celal Bayar University, Manisa, Turkey
  10. 10Meyer Hospital CF Regional Centre, Florence, Pediatric Department, Italy
  11. 11Department of Psychiatry, Children's Hospital Boston, Boston, Massachusetts, USA
  12. 12Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island, USA
  1. Correspondence to Dr Alexandra L Quittner, Department of Psychology & Pediatrics, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL 33146, USA; aquittner{at}


Background Individuals with chronic diseases and parent caregivers are at increased risk for symptoms of depression and anxiety. Prevalence of psychological symptoms was evaluated in adolescents and adults with cystic fibrosis (CF) and parent caregivers across nine countries.

Methods Patients with CF, ages 12 years and older, and caregivers of children with CF, birth to18 years of age, completed measures of depression and anxiety across 154 CF centres in Europe and the USA. Psychological symptoms were compared across countries using χ2. Logistic regression examined extent of comorbid symptoms, predictors of depression and anxiety, and concordance between parent and adolescent symptomatology.

Results Psychological symptoms were reported by 6088 patients with CF and 4102 parents. Elevated symptoms of depression were found in 10% of adolescents, 19% of adults, 37% of mothers and 31% of fathers. Elevations in anxiety were found in 22% of adolescents, 32% of adults, 48% of mothers and 36% of fathers. Overall, elevations were 2–3 times those of community samples. Participants reporting elevated anxiety were more likely to report depression (ORs: adolescents=14.97, adults=13.64, mothers=15.52, fathers=9.20). Significant differences in reports of depression and anxiety were found by patient age and parent respondent. Concordance between 1122 parent–teen dyads indicated that adolescents whose parents reported depression were more likely to be elevated on depression (OR=2.32). Similarly, adolescents whose parents reported anxiety were more likely to score in the elevated range on the anxiety measure (OR=2.22).

Conclusions Symptoms of depression and anxiety were elevated in both patients with CF and parents across several European countries and the USA. Annual screening of psychological symptoms is recommended for both patients and parents.

  • Cystic Fibrosis
  • Psychology
  • Paediatric Lung Disaese

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