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Letter to the editor: authors’ response
  1. Alexandra L Quittner1,
  2. Dave Barker2,
  3. Lutz Goldbeck3,
  4. Alistair Duff4,
  5. Janice Abbott5
  1. 1 Department of Psychology & Pediatrics, University of Miami, Coral Gables, Florida, USA
  2. 2 Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island, USA
  3. 3 Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Ulm, Germany
  4. 4 The Regional Paediatric CF Unit, Leeds Teaching Hospitals NHS Trust, Leeds , UK
  5. 5 School of Psychology, University of Central Lancashire, Preston, UK
  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}

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Dear editors

We thank Drs Webb and Bryon for their comments1 on our TIDES paper.2 We are responding to their critiques of our study. Beyond clarifying the ‘devilish details’ they highlighted, we want to emphasise the clinical significance of our results2—a substantial proportion of our patients reported elevated symptoms of depression (17%) and anxiety (29%) across nine countries. Higher rates were reported by parents: depression (37.3% of mothers, 31.3% of fathers) and anxiety (47.8% of mothers, 35.2% of fathers). Although the ‘absolute’ number of individuals who have depression or anxiety is difficult to ascertain with any screening tool, it is clear that psychological distress is common and has been associated with worse: self-management, pulmonary function, quality of life, and increased hospitalisations and healthcare costs.3 ,4 We can no longer minimise the extent of the problem and its impact on the health of individuals with CF.

Our response to the ‘details’: First, 6088 participants completed the depression and anxiety screening, with a small …

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