Decreased survival in cystic fibrosis patients with a positive screen for depression
Open accessAbstract
Background The International Depression Epidemiological Study (TIDES) found elevated rates of screen positivity for depression and anxiety among individuals with cystic fibrosis (CF). Depression is associated with worse adherence and health-related quality of life in CF. We investigated the relationship with mortality. Methods Subjects were untransplanted participants in TIDES 12+ years of age receiving care at one of 45 collaborating US CF care centers who completed the Hospital Anxiety and Depression Scale and/or Center for Epidemiologic Studies Depression Scale during a stable visit between 2006 and 2010. Clinical characteristics and mortality data were obtained from the CF Foundation Patient Registry. The association of a positive screen with 5-year survival was evaluated using Cox Proportional Hazards modeling. Results Of 1005 eligible patients, 25% screened positive for depression and 34% screened positive for anxiety. Patients who screened positive for depression were more likely to be older, have a residual function mutation, public insurance, and more pulmonary exacerbations in the screening year. There were 96 deaths. The unadjusted 5-year Hazard Ratio (HR) for death among those with depression was 2.0; 95% CI (1.3, 3.0)]. When adjusted for predetermined potential confounders the HR for the entire population was 1.4; 95% CI (0.9, 2.2). The adjusted HR was higher in adults [1.6; 95% CI (1.0, 2.4)] and those screening in the severe range [2.0; 95% CI (1.2, 3.4)]. Anxiety was not associated with mortality. Conclusions A positive depression screen is associated with increased mortality among adults with CF. Research into the etiology of this relationship is needed.
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A positive depression screen is associated with earlier mortality.
“A positive depression screen has also been associated with earlier mortality [20].”
From Rates of depression and anxiety in Italian patients with cystic fibrosis and parent caregivers: Implementation of the Mental Health Guidelines (2020) · cites this paper as [20]
Depression is associated with poor adherence, avoidance of clinic visits, greater morbidity and earlier mortality.
“Given that depression, in particular, is associated with poor adherence, avoidance of clinic visits, greater morbidity and earlier mortality, we must implement standardized screening processes and incorporate evidence-based, brief interventions into CF Centers [20].”
From Rates of depression and anxiety in Italian patients with cystic fibrosis and parent caregivers: Implementation of the Mental Health Guidelines (2020) · cites this paper as [20]
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Georgiopoulos, A. M., Smith, B. A., Aliaj, E., Riva, D., Davis, K., Lomas, P., Kirby, K., Nowakowski, A. C. H., Shiffman, M., Tillman, L., et al. (2026) · Pediatric Pulmonology · doi:10.1002/ppul.71472 · Cited by 1 · see citing works
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Self-citationManagement of Adult Bronchiectasis: Consensus-Based Guidelines of the German Respiratory Society
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Self-citationAltered responsiveness to photic stimuli contribute to circadian disruption in cystic fibrosis
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Self-citation
- Authors
- Schechter, M. S., Ostrenga, J. S., Fink, A. K., Barker, D. H., Sawicki, G. S., & Quittner, A. L.
- Affiliations
- Virginia Commonwealth University (US)
- Cystic Fibrosis Foundation (US)
- Rhode Island Hospital (US)
- Boston Children's Hospital (US)
- Miami Children's Hospital (US)
- Corresponding author
- Schechter, Michael S.
- Venue
- Journal of Cystic Fibrosis
- Publisher
- Elsevier BV
- Published
- 2021-01
- Volume
- 20
- Issue
- 1
- Pages
- 120-126
- ISSN
- 1569-1993 (ISSN-L)
- OpenAlex
- W3048599506
- Cited by
- 71
- References
- 35
- Citations by year
- 2026: 11 · 2025: 9 · 2024: 12 · 2023: 13 · 2022: 13 · 2021: 9 · 2020: 3
- FWCI
- 5.36
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Cystic Fibrosis (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Cystic Fibrosis Foundation
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cystic Fibrosis Research Advances
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- depression, anxiety, mortality, depression screening, Hospital Anxiety and Depression Scale, Center for Epidemiologic Studies Depression Scale, tides, adults with cystic fibrosis
- MeSH terms
- Adolescent, Anxiety, Cystic Fibrosis, Depression, Female, Humans, Male, Survival Rate
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