The International Depression Epidemiological Study (TIDES): unfinished business?

Abstract

The remarkable improvement in survival for patients with cystic fibrosis (CF) is one of the great success stories of modern clinical medicine. Over a period of three decades, a disease associated with childhood dying (as parents of CF children were informed) has become one of adulthood survival into the fifth and sixth decades of life. CF is the most complex of diseases. It remains (despite recent advances) a chronic multisystem incurable disease in a survivor population who are beginning to lead normal working and domestic lives. This improved survival is a direct result of holistic care delivered by multidisciplinary teams (MDT) based in paediatric and adult CF centres.1 The establishment of CF centres around the world has enabled large evidence-based clinical trials, patient registries, best practice guidelines and thereby patient-centred care. Although CF patients appear to cope remarkably well with a disease which places a huge burden of care on an often busy working and social life, it is not surprising as detailed in several small series that CF patients suffer to varying degrees from heightened anxiety and depression.2–4 There is a non-negotiable requirement of CF adults and children to provide lifelong self-care to maintain disease stability and to make the most of a normal quality of life. Perceived poor quality of life can result in a despondency with treatment and poor adherence to the daily regimen leads quickly to deterioration of health.5 ,6 Lifelong medical conditions are not managed by medicine alone, there is a psychological cost and this paper is commended for having elevated the issue of potential psychological impairment in CF. The provision of expert psychosocial care is an essential …