Psychological Characteristics of Adults with Cystic Fibrosis

Abstract

To the Editor:I read with interest the report by Shepherd et al (Chest 1990; 97:1310-16), which demonstrated adequate social functioning among the adult population with cystic fibrosis (CF), but I feel that the psychological characteristics need further investigation.The authors' findings of good functioning in terms of employment, education, and so forth are consistent with those of other studies.1Moise JR Drotar D Doershuk CF Stern RC Correlates of psychosocial adjustment among young adults with cystic fibrosis.J Dev Behav Pediatr. 1987; 8: 141-148Crossref PubMed Scopus (47) Google Scholar“Life satisfaction,” which Shepherd et al also measured, is only a general measure of psychological distress. When psychological distress was investigated in a much larger sample (n = 176), less favorable results were found.2Cowen L Carey M Simmons R Keenan N Robertson J Levison H. Growing older with cystic fibrosis: psychosocial adjustment of patients more than 16 years old.Psychosom Med. 1984; 46: 363-376Crossref PubMed Scopus (43) Google Scholar This may justify investigating the psychological difficulties of adult CF sufferers in more detail.Adult CF patients do not, except rarely, suffer from mental illness. They may experience neurotic symptoms, such as anxiety, low mood, or stress. All people experience these to some extent, so the choice of where to draw a line in psychiatric investigations to define some symptoms as abnormal is critical.3Freeman CP Neurotic disorders.in: Kendell RE Zealley AK 4th ed. Companion to psychiatric studies. Churchill Livingstone, New York1988: 330-354Google Scholar The questionnaires that Shepherd et al developed for their study do appear to genuinely inquire about those areas of life and social satisfaction that the authors intended to investigate. Since these questionnaires are not supported by reliability or validity data, there must remain some doubt that the authors drew their lines in acceptable positions.The authors failed to interview a third of the patients, and this may introduce bias.The adult CF population is expanding. Shepherd et al have increased our knowledge of how they fare. Perhaps future studies should use interviews as a more reliable way of producing psychological data and should use recognized rating scales of known reliability and validity to address in more detail the occurrence of psychological symptoms. To the Editor: I read with interest the report by Shepherd et al (Chest 1990; 97:1310-16), which demonstrated adequate social functioning among the adult population with cystic fibrosis (CF), but I feel that the psychological characteristics need further investigation. The authors' findings of good functioning in terms of employment, education, and so forth are consistent with those of other studies.1Moise JR Drotar D Doershuk CF Stern RC Correlates of psychosocial adjustment among young adults with cystic fibrosis.J Dev Behav Pediatr. 1987; 8: 141-148Crossref PubMed Scopus (47) Google Scholar “Life satisfaction,” which Shepherd et al also measured, is only a general measure of psychological distress. When psychological distress was investigated in a much larger sample (n = 176), less favorable results were found.2Cowen L Carey M Simmons R Keenan N Robertson J Levison H. Growing older with cystic fibrosis: psychosocial adjustment of patients more than 16 years old.Psychosom Med. 1984; 46: 363-376Crossref PubMed Scopus (43) Google Scholar This may justify investigating the psychological difficulties of adult CF sufferers in more detail. Adult CF patients do not, except rarely, suffer from mental illness. They may experience neurotic symptoms, such as anxiety, low mood, or stress. All people experience these to some extent, so the choice of where to draw a line in psychiatric investigations to define some symptoms as abnormal is critical.3Freeman CP Neurotic disorders.in: Kendell RE Zealley AK 4th ed. Companion to psychiatric studies. Churchill Livingstone, New York1988: 330-354Google Scholar The questionnaires that Shepherd et al developed for their study do appear to genuinely inquire about those areas of life and social satisfaction that the authors intended to investigate. Since these questionnaires are not supported by reliability or validity data, there must remain some doubt that the authors drew their lines in acceptable positions. The authors failed to interview a third of the patients, and this may introduce bias. The adult CF population is expanding. Shepherd et al have increased our knowledge of how they fare. Perhaps future studies should use interviews as a more reliable way of producing psychological data and should use recognized rating scales of known reliability and validity to address in more detail the occurrence of psychological symptoms.