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

Astrid Fidika,Marion Herle,Lutz Goldbeck

doi:10.1186/1471-2466-14-205

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.

Highlights

Epidemiological studies report high rates of depression among patients with cystic fibrosis (CF)
To further investigate the association between depression and lung function in patients with CF, we prospectively examined the hypothesis that symptoms of depression would be a predictor lung function in a two-year followup assessment when controlling for baseline disease severity of the CF-related lung disease
Depression and course of FEV1% As expected, a significant main effect of time (F = 5.96; p = .015; η2 = 0.013) indicated an average decrease of about 3% in the FEV1 predicted in our study sample during the two year observation period (Figure 1)

Summary

Introduction

Epidemiological studies report high rates of depression among patients with cystic fibrosis (CF). Prevalence rates for depression range between 6.9% in Europe [10] and 8.6% in the US [11] They point to a major public health issue worldwide. A German study found that nine per cent of adolescent and adult patients with CF show clinically relevant symptoms of depression, similar to the prevalence in the general population [12]. Depression is a known risk factor for poor adherence to treatment more in the case of patients with chronic conditions [17]. Ill patients who screened positive for symptoms of depression have a three-fold higher risk of not adhering to some degree to their medical treatment [18]. Poor adherence to the medical regime limits treatment effectiveness, promotes disease progression and may, reduce survival [19]

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Discussion

Conclusion