Anxiety and depressive disorders in cystic fibrosis (review)

Abstract

Anxiety and depressive disorders aspects are considered in the article, as well as their prevalence among cystic fibrosis patients. Epidemiologic data show that over 20% population suffer from at least one of these disorders (anxiety or depression) during lifespan. Pathogenetic aspects of anxiety and depression development are addressed. Among adult CF patients, 5.6–19% had depression indicators according to HADS scale and 33.4% according to PHQ-9. Significant negative correlation was found between depression and lung function (r=–0.39, р=0.01), anxiety and lung function (r=–0.36, р=0.02). Increased depression symptoms were detected in 10% of adolescents, in 37% cases of mothers and 31% fathers patients with CF; anxiety symptoms — in 22% сases of adolescents, in 32% of adults with CF, and in 48% of mothers and 36% of fathers of CF patients; on the whole, 2-3 times higher than in general population. Treating depression and anxiety syndrome in CF patients should include cognitive-behaviour therapy and psychotherapy. Examination of parents of CF patients after cognitive-behaviour therapy demonstrated significant decrease of anxiety symptoms (approximately by 5 points, from heightened to normal levels). Fear of disease progression (p<0.001) and depression symptoms (p=0.02) also decreased significantly, quality of life indicators related to health improved (p=0.01). The result was preserved at control assessment after 3 months. Conclusion. Today, we do not have sufficient data about psychological interventions to support cystic fibrosis patients and their caregivers. Psychologic interventions should aim specific symptoms of the disease or behavior connecting with diseases.