Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries
Open accessAbstract
BACKGROUND: Individuals with chronic diseases and parent caregivers are at increased risk for symptoms of depression and anxiety. Prevalence of psychological symptoms was evaluated in adolescents and adults with cystic fibrosis (CF) and parent caregivers across nine countries. METHODS: Patients with CF, ages 12 years and older, and caregivers of children with CF, birth to18 years of age, completed measures of depression and anxiety across 154 CF centres in Europe and the USA. Psychological symptoms were compared across countries using χ(2). Logistic regression examined extent of comorbid symptoms, predictors of depression and anxiety, and concordance between parent and adolescent symptomatology. RESULTS: Psychological symptoms were reported by 6088 patients with CF and 4102 parents. Elevated symptoms of depression were found in 10% of adolescents, 19% of adults, 37% of mothers and 31% of fathers. Elevations in anxiety were found in 22% of adolescents, 32% of adults, 48% of mothers and 36% of fathers. Overall, elevations were 2-3 times those of community samples. Participants reporting elevated anxiety were more likely to report depression (ORs: adolescents=14.97, adults=13.64, mothers=15.52, fathers=9.20). Significant differences in reports of depression and anxiety were found by patient age and parent respondent. Concordance between 1122 parent-teen dyads indicated that adolescents whose parents reported depression were more likely to be elevated on depression (OR=2.32). Similarly, adolescents whose parents reported anxiety were more likely to score in the elevated range on the anxiety measure (OR=2.22). CONCLUSIONS: Symptoms of depression and anxiety were elevated in both patients with CF and parents across several European countries and the USA. Annual screening of psychological symptoms is recommended for both patients and parents.
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Claims the paper makes
7 of 31 cited sources checked · 3 supported · 0 flagged · accuracy not yet measured
- Premisecitation
For adults with cystic fibrosis, rates of anxiety have ranged from 30% to 33%.
“rates of anxiety from 30% to 33%.”
Quote in the paperNot a substantial claim2 of 2 sources checked- cites [8] Havermans, 2008, Quality of life in patients with Cystic Fibrosis: association with anxiety and depression, J Cyst Fibros source
Section 3.2 (HADS) reports that 18 of 57 adult patients with cystic fibrosis (30%) scored in the borderline/clinical anxiety category. Our copy does not report a 33% rate, so it supports the lower end of the stated range but not the upper end. (LLM, conf=0.88)
Experimental — accuracy not yet measured - cites [10] Yohannes, 2012, Relationship between anxiety, depression, and quality of life in adult patients with cystic fibrosis, Respir Care source
- Findingcitation
The vast majority of items on the Hospital Anxiety and Depression Scale depression subscale measured anhedonia (72%).
“Instead, the vast majority of items on the HADS-D measured anhedonia (72%), which represents lack of enjoyment and pleasure in activities.36”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [36] American Psychiatric Association, 2013 source
The Symptoms and patterns passage (section dated 11 September 2026; no page given) describes loss of pleasure or interest in activities, supporting the sentence’s explanation of anhedonia. It does not discuss HADS-D items or report that 72% measure anhedonia; searches for those terms found no such passage. (LLM, conf=0.82)
Experimental — accuracy not yet measured
- Findingown data
In fathers of children with cystic fibrosis, elevations in anxiety were found in 36%.
“Elevations in anxiety were found in 22% of adolescents, 32% of adults, 48% of mothers and 36% of fathers.”
- Also stated in: § Prevalence of symptoms of anxiety · plain
“Symptoms of anxiety were prevalent in patients and parents: adolescents 22%, adults 32%, mothers 48% and fathers 36% (see table 1 and figure 1).”
Quote in the paperNot a substantial claim - Also stated in: § Prevalence of symptoms of anxiety · plain
- Findingown data
In adolescents with cystic fibrosis, elevations in anxiety were found in 22%.
“Elevations in anxiety were found in 22% of adolescents, 32% of adults, 48% of mothers and 36% of fathers.”
- Also stated in: § Prevalence of symptoms of anxiety · plain
“Symptoms of anxiety were prevalent in patients and parents: adolescents 22%, adults 32%, mothers 48% and fathers 36% (see table 1 and figure 1).”
Quote in the paperNot a substantial claim - Also stated in: § Prevalence of symptoms of anxiety · plain
- Findingown data
In adults with cystic fibrosis, elevated symptoms of depression were found in 19%.
“Elevated symptoms of depression were found in 10% of adolescents, 19% of adults, 37% of mothers and 31% of fathers.”
Quote in the paperSubstantial claim
- Findingown data
Adolescents with cystic fibrosis reporting elevated anxiety had 14.97 times higher odds of reporting depression than those not reporting anxiety.
“Participants reporting elevated anxiety were more likely to report depression (ORs: adolescents=14.97,adults=13.64,mothers=15.52,fathers=9.20).”
Quote in the paperSubstantial claim - Findingown data
Mothers reporting elevated anxiety had 15.52 times higher odds of reporting depression than those not reporting anxiety.
“Participants reporting elevated anxiety were more likely to report depression (ORs: adolescents=14.97,adults=13.64,mothers=15.52,fathers=9.20).”
Quote in the paperSubstantial claim - Findingown data
In adults with cystic fibrosis, elevations in anxiety were found in 32%.
“Elevations in anxiety were found in 22% of adolescents, 32% of adults, 48% of mothers and 36% of fathers.”
- Also stated in: § Prevalence of symptoms of anxiety · plain
“Symptoms of anxiety were prevalent in patients and parents: adolescents 22%, adults 32%, mothers 48% and fathers 36% (see table 1 and figure 1).”
Quote in the paperNot a substantial claim - Also stated in: § Prevalence of symptoms of anxiety · plain
- Findingown data
Adults with cystic fibrosis reporting elevated anxiety had 13.64 times higher odds of reporting depression than those not reporting anxiety.
“Participants reporting elevated anxiety were more likely to report depression (ORs: adolescents=14.97,adults=13.64,mothers=15.52,fathers=9.20).”
Quote in the paperSubstantial claim - Findingown data
In mothers of children with cystic fibrosis, elevations in anxiety were found in 48%.
“Elevations in anxiety were found in 22% of adolescents, 32% of adults, 48% of mothers and 36% of fathers.”
- Also stated in: § Prevalence of symptoms of anxiety · plain
“Symptoms of anxiety were prevalent in patients and parents: adolescents 22%, adults 32%, mothers 48% and fathers 36% (see table 1 and figure 1).”
Quote in the paperNot a substantial claim - Also stated in: § Prevalence of symptoms of anxiety · plain
- Findingown data
In adolescents with cystic fibrosis, elevated symptoms of depression were found in 10%.
“Elevated symptoms of depression were found in 10% of adolescents, 19% of adults, 37% of mothers and 31% of fathers.”
Quote in the paperNot a substantial claim - Findingown data
In mothers of children with cystic fibrosis, elevated symptoms of depression were found in 37%.
“Elevated symptoms of depression were found in 10% of adolescents, 19% of adults, 37% of mothers and 31% of fathers.”
Quote in the paperNot a substantial claim - Findingown data
In fathers of children with cystic fibrosis, elevated symptoms of depression were found in 31%.
“Elevated symptoms of depression were found in 10% of adolescents, 19% of adults, 37% of mothers and 31% of fathers.”
Quote in the paperNot a substantial claim - Findingown data
Concordance between 1122 parent-teen dyads indicated that adolescents whose parents reported depression were more likely to be elevated on depression (OR=2.32).
“Concordance between 1122 parentteen dyads indicated that adolescents whose parents reported depression were more likely to be elevated on depression (OR=2.32).”
Quote in the paperSubstantial claim - Findingown data
For adults with cystic fibrosis, older age was associated with depression.
“For adults, depression was associated with: older age, lower FEV 1 % predicted, haemoptysis or pneumothorax in the past 6 months, recently on intravenous antibiotics, listed for transplant, taking psychiatric medications and receiving psychotherapy.”
Quote in the paperNot a substantial claim - Findingown data
For the 1122 dyads, adolescents were 2.22 times more likely to be above the cut-off for anxiety if their parent was also elevated.
“and they were 2.22 times more likely to be above the cut-off for anxiety if their parent was also elevated.”
Quote in the paperSubstantial claim - Findingown data
For adolescents with cystic fibrosis, receiving psychotherapy was associated with elevated anxiety.
“Characteristics associated with elevated anxiety were: being female, recently on IV antibiotics and receiving psychotherapy.”
Quote in the paperNot a substantial claim - Findingown data
Overall, 27% of patients were elevated on the Center for Epidemiologic Studies-Depression scale (range 20%-31%).
“and 27% of patients were elevated on the CES-D (range 20%-31%)”
Quote in the paperNot a substantial claim - Findingown data
For adolescents with cystic fibrosis, recently being on intravenous antibiotics was associated with elevated anxiety.
“Characteristics associated with elevated anxiety were: being female, recently on IV antibiotics and receiving psychotherapy.”
Quote in the paperNot a substantial claim - Findingown data
Mothers reported significantly more symptoms of anxiety than fathers (48% vs 36%, p<0.001).
“Mothers also reported significantly more symptoms of anxiety than fathers (48% vs. 36%, p<0.001).”
Quote in the paperNot a substantial claim - Findingown data
Comparing the Center for Epidemiologic Studies-Depression scale with the Hospital Anxiety and Depression Scale depression subscale, the odds ratio for adolescents was 4.45 (p<0.001).
“Comparing the CES-D with the HADS-D, the OR for adolescents was 4.45 ( p<0.001)”
Quote in the paperNot a substantial claim - Findingown data
31% of mothers reported elevations on both anxiety and depression.
“31% reported elevations on both.”
Quote in the paperNot a substantial claim - Findingown data
14% of adults reported elevations on both anxiety and depression.
“14% of adults reported elevations on both.”
Quote in the paperNot a substantial claim - Findingown data
For adolescents with cystic fibrosis, an episode of haemoptysis/pneumothorax in the past 6 months was associated with elevated symptoms of depression.
“For adolescents, the following characteristics were associated with elevated symptoms of depression on the CES-D or HADS-D: being female, an episode of haemoptysis/pneumothorax in past 6 months, taking psychiatric medication for depression or anxiety and receiving psychotherapy for depression or anxiety.”
Quote in the paperSubstantial claim - Findingown data
6% of adolescents reported elevations on both anxiety and depression.
“6% of adolescents reported elevations on both.”
Quote in the paperNot a substantial claim - Findingown data
Adolescents reported fewer symptoms of depression than adults (19% vs 29% on the Center for Epidemiologic Studies-Depression scale; p<0.001).
“Statistically significant differences were found by age (see table 1), with adolescents reporting fewer symptoms of depression than adults (19% vs. 29% on the CES-D; p<0.001).”
Quote in the paperNot a substantial claim - Findingown data
For the 1122 dyads with both parent and teen reports, adolescents were 2.39 times more likely to be above the cut-off for depression if at least one of their parents had elevated symptoms.
“For the 1122 dyads with both parent and teen reports, adolescents were 2.39 times more likely be above the cut-off for depression if at least one of their parents had elevated symptoms”
Quote in the paperNot a substantial claim - Findingown data
Comparing the Center for Epidemiologic Studies-Depression scale with the Hospital Anxiety and Depression Scale depression subscale, the odds ratio for fathers was 1.09 (p=0.650).
“and for fathers it was 1.09 ( p=0.650).”
Quote in the paperNot a substantial claim - Findingown data
Comparing the Center for Epidemiologic Studies-Depression scale with the Hospital Anxiety and Depression Scale depression subscale, the odds ratio for mothers was 1.88 (p<0.001).
“For mothers, the OR was 1.88 ( p <0.001)”
Quote in the paperNot a substantial claim - Findingown data
Significant differences in reports of depression and anxiety were found by patient age and parent respondent.
“Significant differences in reports of depression and anxiety were found by patient age and parent respondent.”
Quote in the paperSubstantial claim - Findingown data
Overall, 11% of patients were elevated on the Hospital Anxiety and Depression Scale depression subscale (range 8%-15%).
“Analyses by country indicated that overall, 11% of patients were elevated on the HADS-D (range 8%-15%)”
Quote in the paperNot a substantial claim - Findingown data
In Turkey, depression on the Hospital Anxiety and Depression Scale depression subscale was 29%.
“Turkey: depression on the HADS-D=29%”
Quote in the paperNot a substantial claim - Findingown data
For adolescents with cystic fibrosis, being female was associated with elevated anxiety.
“Characteristics associated with elevated anxiety were: being female, recently on IV antibiotics and receiving psychotherapy.”
Quote in the paperNot a substantial claim - Findingown data
Fathers reporting elevated anxiety had 9.20 times higher odds of reporting depression than those not reporting anxiety.
“Participants reporting elevated anxiety were more likely to report depression (ORs: adolescents=14.97,adults=13.64,mothers=15.52,fathers=9.20).”
Quote in the paperSubstantial claim - Findingown data
For adolescents with cystic fibrosis, receiving psychotherapy for depression or anxiety was associated with elevated symptoms of depression.
“For adolescents, the following characteristics were associated with elevated symptoms of depression on the CES-D or HADS-D: being female, an episode of haemoptysis/pneumothorax in past 6 months, taking psychiatric medication for depression or anxiety and receiving psychotherapy for depression or anxiety.”
Quote in the paperNot a substantial claim - Findingown data
For adolescents with cystic fibrosis, being female was associated with elevated symptoms of depression on the Center for Epidemiologic Studies-Depression scale or Hospital Anxiety and Depression Scale depression subscale.
“For adolescents, the following characteristics were associated with elevated symptoms of depression on the CES-D or HADS-D: being female, an episode of haemoptysis/pneumothorax in past 6 months, taking psychiatric medication for depression or anxiety and receiving psychotherapy for depression or anxiety.”
Quote in the paperSubstantial claim - Findingown data
21% of fathers reported elevations on both anxiety and depression.
“21% reported elevations on both.”
Quote in the paperNot a substantial claim - Findingown data
Mothers reported significantly more depressive symptoms than fathers on the Center for Epidemiologic Studies-Depression scale (34% vs 25%; p<0.001).
“Mothers reported significantly more depressive symptoms than fathers on the CES-D (34% vs. 25%; p<0.001)”
Quote in the paperNot a substantial claim - Findingown data
Adolescents whose parents reported anxiety were more likely to score in the elevated range on the anxiety measure (OR=2.22).
“Similarly, adolescents whose parents reported anxiety were more likely to score in the elevated range on the anxiety measure (OR=2.22).”
Quote in the paperNot a substantial claim - Findingown data
Comparing the Center for Epidemiologic Studies-Depression scale with the Hospital Anxiety and Depression Scale depression subscale, the odds ratio for adults was 2.90 (p<0.001).
“and the OR for adults was 2.90 ( p<0.001).”
Quote in the paperNot a substantial claim - Findingown data
For adolescents with cystic fibrosis, taking psychiatric medication for depression or anxiety was associated with elevated symptoms of depression.
“For adolescents, the following characteristics were associated with elevated symptoms of depression on the CES-D or HADS-D: being female, an episode of haemoptysis/pneumothorax in past 6 months, taking psychiatric medication for depression or anxiety and receiving psychotherapy for depression or anxiety.”
Quote in the paperNot a substantial claim - Findingown data
Mothers did not report significantly more depressive symptoms than fathers on the Hospital Anxiety and Depression Scale depression subscale (20% vs 18%).
“but not on the HADS-D (20% vs. 18%).”
Quote in the paperNot a substantial claim - Findingown data
For mothers, recent intravenous antibiotics was associated with elevated anxiety.
“Elevated anxiety was associated with: younger age, recent intravenous antibiotics and receiving psychotherapy.”
Quote in the paperNot a substantial claim - Findingown data
For adults with cystic fibrosis, being female was associated with elevated symptoms of anxiety.
“Characteristics associated with elevated symptoms of anxiety were: older age, being female, lower BMI, lower FEV 1 , haemoptysis/pneumothorax, listed for transplant, taking psychiatric medications and receiving psychotherapy.”
Quote in the paperNot a substantial claim - Findingown data
The symptoms with the highest severity ratings focused on hopefulness about the future, self-esteem and extent of happiness.
“In fact, the symptoms with the highest severity ratings focused on hopefulness about the future, selfesteem and extent of happiness.”
Quote in the paperNot a substantial claim - Findingown data
For adults with cystic fibrosis, being listed for transplant was associated with elevated symptoms of anxiety.
“Characteristics associated with elevated symptoms of anxiety were: older age, being female, lower BMI, lower FEV 1 , haemoptysis/pneumothorax, listed for transplant, taking psychiatric medications and receiving psychotherapy.”
Quote in the paperNot a substantial claim - Findingown data
A comparison of items on the Hospital Anxiety and Depression Scale depression subscale and the Center for Epidemiologic Studies-Depression scale revealed that many of the diagnostic criteria in the DSM-IV/V were not represented on the Hospital Anxiety and Depression Scale depression subscale (e.g., cognitive impairment, lack of energy).
“Further, a comparison of items on the HADS-D and CES-D revealed that many of the diagnostic criteria in the DSM-IV/V were not represented on the HADS-D (e.g., cognitive impairment, lack of energy).”
Quote in the paperSubstantial claim - Findingown data
For adults with cystic fibrosis, haemoptysis/pneumothorax was associated with elevated symptoms of anxiety.
“Characteristics associated with elevated symptoms of anxiety were: older age, being female, lower BMI, lower FEV 1 , haemoptysis/pneumothorax, listed for transplant, taking psychiatric medications and receiving psychotherapy.”
Quote in the paperNot a substantial claim - Findingown data
Elevated depression was reported by 17% of patients across countries, regardless of which screening tool was used.
“Elevated depression was reported by 17% of patients across countries, regardless of which screening tool was used”
Quote in the paperSubstantial claim - Findingown data
For adults with cystic fibrosis, lower FEV1% predicted was associated with depression.
“For adults, depression was associated with: older age, lower FEV 1 % predicted, haemoptysis or pneumothorax in the past 6 months, recently on intravenous antibiotics, listed for transplant, taking psychiatric medications and receiving psychotherapy.”
Quote in the paperSubstantial claim - Findingown data
For adults with cystic fibrosis, receiving psychotherapy was associated with elevated symptoms of anxiety.
“Characteristics associated with elevated symptoms of anxiety were: older age, being female, lower BMI, lower FEV 1 , haemoptysis/pneumothorax, listed for transplant, taking psychiatric medications and receiving psychotherapy.”
Quote in the paperNot a substantial claim - Findingown data
For mothers, receiving psychotherapy was associated with depression.
“For mothers, child characteristics associated with depression were: recently on intravenous antibiotics and receiving psychotherapy.”
Quote in the paperNot a substantial claim - Findingown data
For mothers, younger age was associated with elevated anxiety.
“Elevated anxiety was associated with: younger age, recent intravenous antibiotics and receiving psychotherapy.”
Quote in the paperNot a substantial claim - Findingown data
Older age was associated with elevated depression and anxiety in the study sample of patients with cystic fibrosis and parent caregivers.
“Older age and female sex, worse disease severity, as indicated by lower lung function or BMI, and recent changes in health status ( past 6 months), such as haemoptysis or prescription of intravenous antibiotics.”
Quote in the paperNot a substantial claim - Findingown data
In parents, current treatment for a psychological disorder was associated with greater symptomatology.
“For parents, recent course of intravenous antibiotics and current treatment for a psychological disorder were associated with greater symptomatology.”
Quote in the paperSubstantial claim - Findingown data
For mothers, child recently being on intravenous antibiotics was associated with depression.
“For mothers, child characteristics associated with depression were: recently on intravenous antibiotics and receiving psychotherapy.”
Quote in the paperNot a substantial claim - Findingown data
For adults with cystic fibrosis, older age was associated with elevated symptoms of anxiety.
“Characteristics associated with elevated symptoms of anxiety were: older age, being female, lower BMI, lower FEV 1 , haemoptysis/pneumothorax, listed for transplant, taking psychiatric medications and receiving psychotherapy.”
Quote in the paperNot a substantial claim - Findingown data
For adults with cystic fibrosis, receiving psychotherapy was associated with depression.
“For adults, depression was associated with: older age, lower FEV 1 % predicted, haemoptysis or pneumothorax in the past 6 months, recently on intravenous antibiotics, listed for transplant, taking psychiatric medications and receiving psychotherapy.”
Quote in the paperNot a substantial claim - Findingown data
For adults with cystic fibrosis, taking psychiatric medications was associated with elevated symptoms of anxiety.
“Characteristics associated with elevated symptoms of anxiety were: older age, being female, lower BMI, lower FEV 1 , haemoptysis/pneumothorax, listed for transplant, taking psychiatric medications and receiving psychotherapy.”
Quote in the paperNot a substantial claim - Findingown data
For fathers, recent intravenous antibiotics was associated with depression.
“For fathers, only one child medical variable was associated with depression: recent intravenous antibiotics.”
Quote in the paperNot a substantial claim - Findingown data
For adults with cystic fibrosis, lower FEV1 was associated with elevated symptoms of anxiety.
“Characteristics associated with elevated symptoms of anxiety were: older age, being female, lower BMI, lower FEV 1 , haemoptysis/pneumothorax, listed for transplant, taking psychiatric medications and receiving psychotherapy.”
Quote in the paperNot a substantial claim - Findingown data
For mothers, receiving psychotherapy was associated with elevated anxiety.
“Elevated anxiety was associated with: younger age, recent intravenous antibiotics and receiving psychotherapy.”
Quote in the paperNot a substantial claim - Findingown data
For adults with cystic fibrosis, lower BMI was associated with elevated symptoms of anxiety.
“Characteristics associated with elevated symptoms of anxiety were: older age, being female, lower BMI, lower FEV 1 , haemoptysis/pneumothorax, listed for transplant, taking psychiatric medications and receiving psychotherapy.”
Quote in the paperNot a substantial claim - Findingown data
A posthoc analysis of the rank ordering of depressive symptoms on the Center for Epidemiologic Studies-Depression scale in the patient sample showed that no somatic items were ranked among the top three.
“A posthoc analysis of the rank ordering of depressive symptoms on the CES-D in our patient sample, showed that no somatic items were ranked among the top three.”
Quote in the paperSubstantial claim - Findingown data
Female sex was associated with elevated depression and anxiety in the study sample of patients with cystic fibrosis and parent caregivers.
“Older age and female sex, worse disease severity, as indicated by lower lung function or BMI, and recent changes in health status ( past 6 months), such as haemoptysis or prescription of intravenous antibiotics.”
Quote in the paperSubstantial claim - Findingown data
For adults with cystic fibrosis, haemoptysis or pneumothorax in the past 6 months was associated with depression.
“For adults, depression was associated with: older age, lower FEV 1 % predicted, haemoptysis or pneumothorax in the past 6 months, recently on intravenous antibiotics, listed for transplant, taking psychiatric medications and receiving psychotherapy.”
Quote in the paperNot a substantial claim - Findingown data
For adults with cystic fibrosis, recently being on intravenous antibiotics was associated with depression.
“For adults, depression was associated with: older age, lower FEV 1 % predicted, haemoptysis or pneumothorax in the past 6 months, recently on intravenous antibiotics, listed for transplant, taking psychiatric medications and receiving psychotherapy.”
Quote in the paperNot a substantial claim - Findingown data
Recent changes in health status in the past 6 months, such as haemoptysis or prescription of intravenous antibiotics, were associated with elevated depression and anxiety in the study sample.
“Older age and female sex, worse disease severity, as indicated by lower lung function or BMI, and recent changes in health status ( past 6 months), such as haemoptysis or prescription of intravenous antibiotics.”
Quote in the paperSubstantial claim - Findingown data
Worse disease severity, indicated by lower lung function or BMI, was associated with elevated depression and anxiety in the study sample.
“Older age and female sex, worse disease severity, as indicated by lower lung function or BMI, and recent changes in health status ( past 6 months), such as haemoptysis or prescription of intravenous antibiotics.”
Quote in the paperSubstantial claim - Findingown data
In parents, a recent course of intravenous antibiotics was associated with greater symptomatology.
“For parents, recent course of intravenous antibiotics and current treatment for a psychological disorder were associated with greater symptomatology.”
Quote in the paperNot a substantial claim - Findingown data
For adults with cystic fibrosis, taking psychiatric medications was associated with depression.
“For adults, depression was associated with: older age, lower FEV 1 % predicted, haemoptysis or pneumothorax in the past 6 months, recently on intravenous antibiotics, listed for transplant, taking psychiatric medications and receiving psychotherapy.”
Quote in the paperNot a substantial claim - Findingown data
Treatments for psychological distress (with medication or psychotherapy) were the highest risk factors for elevated depression and anxiety.
“Treatments for psychological distress (with medication or psychotherapy) were the highest risk factors.”
Quote in the paperSubstantial claim - Findingown data
For adults with cystic fibrosis, being listed for transplant was associated with depression.
“For adults, depression was associated with: older age, lower FEV 1 % predicted, haemoptysis or pneumothorax in the past 6 months, recently on intravenous antibiotics, listed for transplant, taking psychiatric medications and receiving psychotherapy.”
Quote in the paperNot a substantial claim - Interpretationown data
Overall, elevations of depression and anxiety in patients with cystic fibrosis and parents were 2-3 times those of community samples.
“Overall, elevations were 2-3 times those of community samples.”
Quote in the paperSubstantial claim - Premisecitation
Overall, psychological symptoms appear to be higher in this population than community samples.
“Overall, psychological symptoms appear to be higher in this population than community samples”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [13] Costello, 2006, Is there an epidemic of child or adolescent depression?, J Child Psychol Psychiatry source
- Study design and conductown data
The amount of missing data from participants who did not provide a response ranged from 0% to 7%, depending on the measure.
“The amount of missing data from participants who did not provide a response ranged from 0% to 7%, depending on the measure.”
Quote in the paperSubstantial claim - Interpretationown data
Symptoms of depression and anxiety were elevated in both patients with cystic fibrosis and parents across several European countries and the USA.
“Symptoms of depression and anxiety were elevated in both patients with CF and parents across several European countries and the USA.”
Quote in the paperSubstantial claim - Premisecitation
Adolescents with cystic fibrosis who had been diagnosed with a depressive disorder were three times more likely to be hospitalised for a pulmonary exacerbation than matched non-depressed teens with cystic fibrosis.
“A recent study 16 compared adolescents with CF who had been diagnosed with a depressive disorder with a matched sample of non-depressed teens with CF, and found that those who were depressed were three times more likely to be hospitalised for a pulmonary exacerbation”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [16] Snell, Depression, illness severity, and healthcare utilization in cystic fibrosis, Pediatr Pulmonol
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Premisecitation
Rates of depression in children and adolescents with cystic fibrosis have ranged from 9% to 29%, using different methods of assessment.
“Rates of depression in children and adolescents have ranged from 9% to 29%, using different methods of assessment”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [7] Smith, 2010, Depressive symptoms in children with cystic fibrosis and parents and its effects on adherence to airway clearance, Pediatr Pulmonol source
- Premisecitation
Depressed adolescents with cystic fibrosis incurred much higher healthcare costs over 2 years (US $280 000 vs US$60 116).
“incurred much higher healthcare costs over 2 years (US $280 000 for the depressed group vs. US$60 116 for the nondepressed group).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [16] Snell, Depression, illness severity, and healthcare utilization in cystic fibrosis, Pediatr Pulmonol
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Premisecitation
In screening studies, those who are experiencing the most severe symptoms are less likely to attend regular clinic visits or give informed consent for participation in research.
“In screening studies, those who are experiencing the most severe symptoms are less likely to attend regular clinic visits or give informed consent for participation in research, and thus, these prevalence rates may be an underestimate of the population.37”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [37] Cohen, 2004, Willingness and competence of depressed and schizophrenic inpatients to consent to research, J Am Acad Psychiatry Law
- Interpretationcitation
The rates of anxiety in patients and caregivers are two to three times those reported in community samples.
“These rates are two to three times those reported in community samples.”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [25] Dierker, 2001, Screening for anxiety and depression in early adolescence, J Am Acad Child Adolesc Psychiatry source
- cites [26] Eisenberg, 2007, Prevalence and correlates of depression, anxiety, and suicidality among university students, Am J Orthopsychiatry source
- cites [27] Davis, 2000, Adolescent responses to depressive parental behaviors in problem-solving interactions: Implications for depressive symptoms, J Abnorm Child Psychol source
- Interpretationcitation
The rate of elevated depression in patients with cystic fibrosis is two times that reported in community populations (9.2%).
“a rate two times that reported in community populations (9.2%).23”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [23] Martin, 2006, Validity of the brief patient health questionnaire mood scale (PHQ-9) in the general population, Gen Hosp Psychiatry source
- Interpretationown data
Analyses of parent-adolescent dyads showed that depression or anxiety in either parent doubled the risk that the adolescent would report elevated psychological distress.
“Analyses of parent-adolescent dyads showed that depression or anxiety in either parent doubled the risk that the adolescent would report elevated psychological distress.”
Quote in the paperSubstantial claim - Study design and conductcitation
The demographic and health information from the three largest samples in this study (UK, USA and Germany) appeared quite similar to data in their respective national registries.
“Although the demographic and health information from the three largest samples in this study (UK, USA and Germany) appeared quite similar to data in their respective national registries, 11 15”
Quote in the paperNot a substantial claim0 of 2 sources checked - Interpretationcitation
These prevalence rates may be an underestimate of the population.
“In screening studies, those who are experiencing the most severe symptoms are less likely to attend regular clinic visits or give informed consent for participation in research, and thus, these prevalence rates may be an underestimate of the population.37”
Quote in the paperNot a substantial claim - Study design and conductnone given
This study was limited by the cross-sectional nature of the data collection.
“This study was also limited by the cross-sectional nature of the data collection.”
Quote in the paperNot a substantial claim
- May combine two claims. 12
- Classified as probably not a substantial claim. 13
- The quote only partly states this claim. 2
May combine two claims.
PremisecitationPsychological distress in patients with cystic fibrosis has been associated with negative consequences including worse adherence, worse pulmonary function, increased hospitalisations and healthcare costs, and decreased health-related quality of life.
“Psychological distress in patients with CF has been associated with a number of negative consequences and health outcomes, including worse adherence, 7 14 worse pulmonary function, 10 15 increased hospitalisations and healthcare costs, 16 and decreased health-related quality of life.8 9”
Quote in the paperSubstantial claim2 of 3 sources checked- cites [7] Smith, 2010, Depressive symptoms in children with cystic fibrosis and parents and its effects on adherence to airway clearance, Pediatr Pulmonol source
- cites [14] Grenard, 2011, Depression and medication adherence in the treatment of chronic diseases in the United States: a meta-analysis, J Gen Intern Med source
The Results report a significant association between depression and worse medication adherence across chronic diseases. The citation to this paper is attached to “worse adherence,” not the sentence’s other outcomes. Our copy does not establish that association specifically in patients with cystic fibrosis. (LLM, conf=0.84)
Experimental — accuracy not yet measured - cites [10] Yohannes, 2012, Relationship between anxiety, depression, and quality of life in adult patients with cystic fibrosis, Respir Care source
May combine two claims.
PremisecitationAmong parent caregivers, elevations in psychological distress have been found, with depression ranging from 20% to 35%.
“Among parent caregivers, elevations in psychological distress have also been found, with depression ranging from 20% to 35%.”
Quote in the paperNot a substantial claim1 of 3 sources checked- cites [7] Smith, 2010, Depressive symptoms in children with cystic fibrosis and parents and its effects on adherence to airway clearance, Pediatr Pulmonol source
- cites [11] Latchford, 2013, Screening for depression in a single CF centre, J Cyst Fibros source
- cites [12] Besier, 2011, Anxiety, depression, and life satisfaction in parents caring for children with cystic fibrosis, Pediatr Pulmonol source
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationFor adults with cystic fibrosis, rates of depression have ranged from 13% to 30%.
“For adults with CF, rates of depression have ranged from 13% to 30%”
Quote in the paperNot a substantial claim1 of 2 sources checked- cites [8] Havermans, 2008, Quality of life in patients with Cystic Fibrosis: association with anxiety and depression, J Cyst Fibros source
Section 3.2 (HADS; page not provided) reports that 13% of the adult CF patients scored in the borderline/clinical category for depression. Its 30% figure refers to anxiety, not depression, so the claimed upper end of the depression range is unsupported. (LLM, conf=0.91)
Experimental — accuracy not yet measured - cites [9] Riekert, 2007, The association between depression, lung function, and health-related quality of life among adults with cystic fibrosis, Chest source
The quote only partly states this claim.
Findingown dataIn Turkey, depression on the Center for Epidemiologic Studies-Depression scale was 52%.
“CES-D=52%”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataStatistically significant differences were found by age, with 22% of adolescents vs 32% of adults (p<0.001) reporting elevations in anxiety above the cut-off score.
“Statistically significant differences were found by age, with 22% of adolescents vs. 32% of adults (p<0.001)reporting elevations in anxiety above the cut-off score”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataRates of depression varied depending on age and screening tool: adolescents 5%-19%, adults 13%-29%, mothers 20%-34%, and fathers 18%-25%.
“Rates of depression varied depending on age and screening tool: adolescents 5%-19%, adults 13%-29%, mothers 20%-34% and fathers 18%-25% (table 1 and figure 1).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataAnalyses by country indicated high rates of anxiety among patients (mean 30%), with moderate variability across countries (14%-35%; Turkey falls within this range).
“Analyses by country indicated high rates of anxiety among patients (mean 30%), with moderate variability across countries (14%-35%; Turkey falls within this range).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataRates of anxiety were elevated in patients and caregivers, with 30% of patients and 36%-48% of parents above the clinical cut-off.
“Rates of anxiety were also elevated in patients and caregivers, with 30% of patients and 36%-48% of parents above the clinical cut-off.”
Quote in the paperSubstantial claimThe quote only partly states this claim.
Findingown dataThe Hospital Anxiety and Depression Scale depression subscale underestimated symptoms of depression by a factor of two.
“comparisons indicated that the HADS-D underestimated symptoms of depression by a factor of two.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
PremisecitationMeta-analyses and systematic reviews have indicated that children and adults with chronic diseases, as well as parent caregivers, are at increased risk for depression and anxiety.
“Meta-analyses and systematic reviews have indicated that children and adults with chronic diseases, as well as parent caregivers, are at increased risk for depression and anxiety.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [1][2][3]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).
Premisenone givenStudies evaluating depression and anxiety in patients with cystic fibrosis have generally found a high prevalence of psychological distress.
“Studies evaluating depression and anxiety in patients with CF have generally found a high prevalence of psychological distress.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationCystic fibrosis is the most common genetic, life-limiting chronic disease among Caucasian populations.
“Cystic fibrosis (CF) is the most common genetic, life-limiting chronic disease among Caucasian populations”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [4] Sawicki, 2011, Longitudinal assessment of health-related quality of life in an observational cohort of patients with cystic fibrosis, Pediatr Pulmonol source
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataIn analyses that pooled data across countries, nesting of participants within 9 countries was accounted for by including country as a fixed effect.
“In analyses that pooled data across countries, this nesting was accounted for by including country as a fixed effect (i.e., different intercept for each country) in the models.”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductown dataBecause few participant responses were missing, this was unlikely to significantly bias the results, and complete cases were used in all analyses.
“Because few participant responses were missing, this was unlikely to significantly bias the results, and we opted to use complete cases in all analyses.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationThe Hospital Anxiety and Depression Scale has extensive reliability and validity data and was designed specifically for patients with chronic medical conditions.
“It has extensive reliability and validity data, and was designed specifically for patients with chronic medical conditions (i.e., removal of somatic items).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [18] Zigmond, 1983, The hospital anxiety and depression scale, Acta Psychiatric Scand source
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe Center for Epidemiologic Studies-Depression scale is a well-established self-report measure of depressive symptomatology for community samples.
“The CES-D is a well-established self-report measure of depressive symptomatology for community samples.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [19] Radloff, 1991, The use of the Center for Epidemiologic Studies Depression Scale in adolescents and young adults, J Youth Adolesc source
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationCystic fibrosis requires a treatment regimen that takes between 2 and 4 hours per day.
“requires a treatment regimen that takes between 2 and 4 h per day.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [4] Sawicki, 2011, Longitudinal assessment of health-related quality of life in an observational cohort of patients with cystic fibrosis, Pediatr Pulmonol source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationThe Center for Epidemiologic Studies-Depression scale has 20 items measuring symptoms of depression that reflect diagnostic criteria on the DSM-IV and has correlated well with diagnostic interviews.
“It has 20 items measuring symptoms of depression that reflect diagnostic criteria on the DSM-IV and has correlated well with diagnostic interviews.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [19] Radloff, 1991, The use of the Center for Epidemiologic Studies Depression Scale in adolescents and young adults, J Youth Adolesc source
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenStudy protocols were approved by national and local ethics committees or institutional review boards at all cystic fibrosis centres.
“Study protocols were approved by national and local ethics committees or institutional review boards at all CF centres.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationcitation37% of mothers and 31% of fathers reported clinically elevated depression, which is three times the rate in community samples.
“37% of mothers and 31% of fathers reported clinically elevated depression, which is three times the rate in community samples.23 24”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [23] Martin, 2006, Validity of the brief patient health questionnaire mood scale (PHQ-9) in the general population, Gen Hosp Psychiatry source
- cites [24] Pignone, 2002, Screening for depression in adults: a summary of the evidence for the US Preventive Services Task Force, Ann Intern Med source
Probably not a substantial claim: may not pass S3 (load-bearing).
InterpretationreasoningIt is possible that this sample is not representative of the larger international population.
“it is possible that this sample is not representative of the larger international population.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataComorbidity of anxious and depressive symptoms within individuals was high, suggesting that elevations in anxiety confer a heightened risk for depression.
“As found in prior studies, comorbidity of anxious and depressive symptoms within individuals was high, suggesting that elevations in anxiety confer a heightened risk for depression.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim. May combine two claims.
PremisecitationMore recent evidence has clearly shown that the Hospital Anxiety and Depression Scale has significant problems, including lack of sensitivity, underestimation of symptoms and a three-factor, rather than two-factor structure, and is not recommended for screening.
“more recent evidence has clearly shown that this screening tool has significant problems, including lack of sensitivity, underestimation of symptoms and a threefactor, rather than two-factor structure, and is not recommended for screening.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [33][34][35]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S2 (checkable).
Interpretationown dataThese results highlight the importance of measuring and treating mental health issues in patients and families coping with serious, chronic illnesses.
“These results highlight the importance of measuring and treating mental health issues in patients and families coping with serious, chronic illnesses.”
Quote in the paperNot a substantial claim
The paper relies on this without support.
Prior studies of depression and anxiety in cystic fibrosis have been limited by small sample sizes and different screening or diagnostic tools, making interpretation of the results difficult.
“however, these studies have been limited by small sample sizes and different screening or diagnostic tools, which have made interpretation of the results difficult.”
The paper relies on this without support.
The majority of studies have only assessed symptoms of depression but not anxiety in cystic fibrosis.
“Additionally, the majority of studies have only assessed symptoms of depression but not anxiety.”
The paper relies on this without support.
The Center for Epidemiologic Studies-Depression scale includes items representing the full spectrum of depressive symptoms underlying the construct.
“By contrast, the CES-D included items representing the full spectrum of depressive symptoms underlying this construct.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the TIDES study, only IVs and other markers of pulmonary exacerbations and events, such as hemoptysis, were related to depression and anxiety.
“These results are similar to those found in the TIDES study [12], in which only IVs and other markers of pulmonary exacerbations and events, such as hemoptysis, were related to depression and anxiety.”
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 [12]
The Predictors of depression and anxiety section (p. 1094) links intravenous antibiotics and haemoptysis/pneumothorax with elevated symptoms. But it also identifies associations with age, sex, lung function, BMI, transplant listing, and psychological treatment, so the claim that *only* the stated medical events were related is not supported. (LLM, conf=0.88)
Experimental — accuracy not yet measuredPwCF and their families are at greater risk of mental health issues due to multiple factors.
“Like most chronic conditions, PwCF and their families are at greater risk of mental health issues due to multiple factors (22).”
From Virtual monitoring in CF – the importance of continuous monitoring in a multi-organ chronic condition (2023) · cites this paper as [22]
The Discussion reports depression and anxiety rates two to three times those of community samples in people with CF and parent caregivers. It also identifies several associated risk factors, but does not establish that those factors cause the elevated risk implied by “due to.” (LLM, conf=0.84)
Experimental — accuracy not yet measuredIn that study, elevated symptoms of anxiety were found in 32% of adults, 22% of adolescents, 48% of mothers and 36% of fathers.
“Elevated symptoms of anxiety were found in 32% of adults, 22% of adolescents, 48% of mothers and 36% of fathers [12].”
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 [12]
In the largest mental health screening study to date in nine countries, including 6088 individuals with CF and 4102 parent caregivers, elevated symptoms of depression were found in 19% of adults, 10% of adolescents, 37% of mothers and 31% of fathers.
“In the largest mental health screening study to date in nine countries, which included 6088 individuals with CF and 4102 parent caregivers, a substantial proportion reported elevated symptoms of depression and anxiety.Elevated symptoms of depression were found in 19% of adults, 10% of adolescents, 37% of mothers and 31% of fathers.”
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 [12]
Italian prevalence statistics are higher than those published in the TIDES study.
“These Italian prevalence statistics are higher than those published in the TIDES study [12] most likely because the screening tools recommended in the guidelines are more sensitive to these symptoms [33].”
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 [12]
These results converge with those reported in the TIDES study.
“These results converge with those reported in the TIDES study [12], and suggest that both depression and anxiety should be a focus of interventions.”
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 [12]
The average lung function in this Italian CF Center is substantially higher than that reported by Quon et al. in the US and the TIDES study.
“Average lung function for the sample of 113 adults was 76% predicted (SD = 23), which is substantially higher than the average lung function reported by both the Quon et al.'s in the US [34] and the TIDES study [12].”
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 [12]
In the TIDES study across 9 countries, mean lung function for adults was 62.3% pred.
“In the Quon study of adults, mean FEV 1 % pred was 54.8% and in the TIDES study across 9 countries, mean lung function for adults was 62.3% pred.”
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 [12]
Anxiety and depressive symptoms are 2 to 3 times more common among individuals with cystic fibrosis than the general population.
“Anxiety and depressive symptoms are 2 to 3 times more common among individuals with cystic fibrosis (CF) than the general population [1]”
From ACT with CF: A telehealth and in-person feasibility study to address anxiety and depressive symptoms among people with cystic fibrosis (2021) · cites this paper as [1]
Previous studies found symptoms of depression were elevated in people with CF, with Quittner et al. [20] reporting that among 6088 patients with CF, 5-19% of adolescents and 13-29% of adults had elevated symptoms of depression.
“It is important to note that previous studies found symptoms of depression were elevated in people with CF, with Quittner et al. [20] reporting that among 6088 patients with CF, 5–19% of adolescents and 13–29% of adults had elevated symptoms of depression.”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Adult BMI association is described in the wrong direction
MajorThe text says lower BMI was associated with adult anxiety, but Table 3 reports an odds ratio of 1.03 per BMI unit, indicating higher odds with higher BMI.
“Characteristics associated with elevated symptoms of anxiety were: older age, being female, lower BMI, lower FEV 1 , haemoptysis/pneumothorax, listed for transplant, taking psychiatric medications and receiving psychotherapy.”
“| BMI | 0.99 (0.95 to 1.04) | 0.793 1.03 (1.01 to 1.05) | 0.003 0.99 (0.97 to 1.02) | 0.504 0.98 (0.94 to 1.03) | 0.530 | | | |”
Parent-adolescent depression odds ratios differ
MinorThe abstract gives an odds ratio of 2.32 for depression concordance, whereas the results section gives 2.39 for that comparison.
“adolescents whose parents reported depression were more likely to be elevated on depression (OR=2.32)”
“adolescents were 2.39 times more likely be above the cut-off for depression if at least one of their parents had elevated symptoms”
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Self-citation
Flagged first, then by citations
Research works printed but not linked: 1
- Quittner, 2012, Treatment adherence in adolescents with cystic fibrosis, 77
Cited by
Sorted by citations
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Elborn, J. S., Bell, S. C., Madge, S. L., Burgel, P., Castellani, C., Conway, S., Rijcke, K. D., Dembski, B., Dřevı́nek, P., Heijerman, H. G. M., et al. (2015) · European Respiratory Journal · doi:10.1183/13993003.00592-2015 · Cited by 120 · see citing works
Self-citationThe psychological burden of cystic fibrosis
Quittner, A. L., Saez-Flores, E., & Barton, J. D. (2016) · Current Opinion in Pulmonary Medicine · doi:10.1097/mcp.0000000000000244 · Cited by 102 · see citing works
Self-citationDaines, C. L., Tullis, E., Costa, S., Linnemann, R. W., Mall, M. A., McKone, E. F., Polineni, D., Quon, B. S., Ringshausen, F. C., Rowe, S. M., et al. (2023) · European Respiratory Journal · doi:10.1183/13993003.02029-2022 · Cited by 100 · see citing works
Effect of the COVID‐19 pandemic on anxiety among children with cystic fibrosis and their mothers
Şenkalfa, B., Eyüboğlu, T. Ş., Aslan, A. T., Gürsoy, T. R., Soysal, A. Ş., Yapar, D., & ILHAN, M. N. (2020) · Pediatric Pulmonology · doi:10.1002/ppul.24900 · Cited by 90 · see citing works
Goodfellow, N. A., Hawwa, A. F., Reid, A. J. M., Horne, R., Shields, M. D., & McElnay, J. C. (2015) · BMC Pulmonary Medicine · doi:10.1186/s12890-015-0038-7 · Cited by 93 · see citing works
Burgel, P., Southern, K. W., Addy, C., Battezzati, A., Berry, C. A., Bouchara, J., Brokaar, E. J., Brown, A. W., Azevedo, P., Durieu, I., et al. (2024) · Journal of Cystic Fibrosis · doi:10.1016/j.jcf.2024.01.005 · Cited by 94 · see citing works
“These include significant mental health issues around diagnosis, especially when this is unexpected, as is often the case following newborn bloodspot screening [142 – 144].”
BackgroundKnudsen, K. B., Pressler, T., Mortensen, L. H., Jarden, M., Skov, M., Quittner, A. L., Katzenstein, T. L., & Boisen, K. A. (2016) · SpringerPlus · doi:10.1186/s40064-016-2862-5 · Cited by 78 · see citing works
“These Danish results are similar to the highest rates reported in TIDES study, with rates of 29 % reported at centers using the CES-D as a screening tool (Quittner et al. 2014b).”
BackgroundResultInfluentialSelf-citationHenkle, E. M., Aksamit, T. R., BARKER, A. R., Daley, C. L., Griffith, D. E., Leitman, P., Leitman, A., Malanga, E., Marras, T. K., Olivier, K. N., et al. (2016) · Annals of the American Thoracic Society · doi:10.1513/annalsats.201605-387ws · Cited by 77 · see citing works
Self-citationTalwalkar, J. S., Koff, J. L., Lee, H. B., Britto, C. J., Mulenos, A. M., & Georgiopoulos, A. M. (2017) · Psychosomatics · doi:10.1016/j.psym.2017.04.001 · Cited by 78 · see citing works
Factors associated with anxiety in family caregivers of children with chronic diseases
Toledano-Toledano, F., & Moral de la Rubia, J. (2018) · BioPsychoSocial Medicine · doi:10.1186/s13030-018-0139-7 · Cited by 77 · see citing works
Grossoehme, D. H., Szczesniak, R. D., Britton, L., Siracusa, C. M., Quittner, A. L., Chini, B. A., Dimitriou, S. M., & Seid, M. (2015) · Annals of the American Thoracic Society · doi:10.1513/annalsats.201408-379oc · Cited by 76 · see citing works
Self-citationParental Depression and Pancreatic Enzymes Adherence in Children With Cystic Fibrosis
Barker, D., & Quittner, A. L. (2016) · PEDIATRICS · doi:10.1542/peds.2015-2296 · Cited by 75 · see citing works
Self-citationDecreased survival in cystic fibrosis patients with a positive screen for depression
Schechter, M. S., Ostrenga, J. S., Fink, A. K., Barker, D. H., Sawicki, G. S., & Quittner, A. L. (2021) · Journal of Cystic Fibrosis · doi:10.1016/j.jcf.2020.07.020 · Cited by 71 · see citing works
Self-citationSouthern, K. W., Castellani, C., Lammertyn, E. J., Smyth, A. R., VanDevanter, D. R., Koningsbruggen-Rietschel, S. V., Barben, J., Bevan, A., Brokaar, E. J., Collins, S., et al. (2022) · Journal of Cystic Fibrosis · doi:10.1016/j.jcf.2022.10.002 · Cited by 75 · see citing works
Self-citationSocioeconomic Status, Smoke Exposure, and Health Outcomes in Young Children With Cystic Fibrosis
Ong, T., Schechter, M. S., Yang, J., Peng, L., Emerson, J., Gibson, R. L., Morgan, W. J., Rosenfeld, M., & for the EPIC Study Group (2017) · PEDIATRICS · doi:10.1542/peds.2016-2730 · Cited by 69 · see citing works
The Changing Epidemiology of Cystic Fibrosis
Burgel, P., Burnet, E., Regard, L., & Martin, C. (2022) · CHEST Journal · doi:10.1016/j.chest.2022.07.004 · Cited by 67 · see citing works
Iturralde, E., Adams, R. N., Barley, R. C., Bensen, R., Christofferson, M., Hanes, S. J., Maahs, D. M., Milla, C. E., Naranjo, D. M., Shah, A. C., et al. (2017) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2017.05.030 · Cited by 63 · see citing works
Cronly, J., Duff, A. J. A., Riekert, K. A., Fitzgerald, T., Perry, I. J., Lehane, E. A., Horgan, A. M., Howe, B., Chróinín, M. N., & Savage, E. (2018) · Respiratory Care · doi:10.4187/respcare.06356 · Cited by 61 · see citing works
Self-citationQuittner, A. L., Abbott, J., Hussain, S. B., Ong, T., Uluer, A., Hempstead, S. E., Lomas, P., & Smith, B. A. (2020) · Pediatric Pulmonology · doi:10.1002/ppul.24949 · Cited by 58 · see citing works
“The TIDES study was the major impetus for integrating mental health into the specialized medical care for people with CF, given that rates of depression and anxiety were two to three times higher than those found in community samples.(1) Thus, these results led the Cystic Fibrosis Foundation (CFF) and the European Cys…”
BackgroundResultSelf-citationElexacaftor/Tezacaftor/Ivacaftor Treatment and Depression-related Events
Ramsey, B. W., Correll, C. U., DeMaso, D. R., McKone, E. F., Tullis, E. D., Taylor‐Cousar, J. L., Chu, C., Volkova, N. V., Ahluwalia, N., Waltz, D., et al. (2023) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.202308-1525oc · Cited by 57 · see citing works
“…to account for the well-acknowledged high background prevalence of depression symptoms and depression-related events (suicidal ideation, attempts) in the CF population, with the prevalence of depression symptoms estimated to be two to three times higher than that in the general population (22, 23).”
BackgroundAbbott, J., Elborn, J. S., Georgiopoulos, A. M., Goldbeck, L., Marshall, B. C., Sabadosa, K. A., Smith, B. A., & Quittner, A. L. (2015) · Journal of Cystic Fibrosis · doi:10.1016/j.jcf.2014.12.015 · Cited by 56 · see citing works
Self-citationToledano‐Toledano, F., de la Rubia, J. M., Guedea, M. T. D., Nabors, L., Eguiarte, B. E. B., Rocha-Pérez, E., Luna, D., Leyva-López, A., & Rivera-Rivera, L. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17217765 · Cited by 53 · see citing works
“Regarding concurrent validity, the hypothesis was a direct relationship between anxiety and depression with a moderate to high association since both are negative affects [7,11]; in addition, a mixed syndrome of anxiety and depression was expected, in which both types of symptoms overlap [37].”
BackgroundUhlenbusch, N., Swaydan, J., Höller, A., Löwe, B., & Depping, M. K. (2021) · Psychological Medicine · doi:10.1017/s0033291721003792 · Cited by 54 · see citing works
Anxiety Contributes to Poorer Asthma Outcomes in Inner-City Black Adolescents
Shams, M. R., Bruce, A. C., & Fitzpatrick, A. M. (2018) · The Journal of Allergy and Clinical Immunology: In Practice · doi:10.1016/j.jaip.2017.06.034 · Cited by 53 · see citing works
“A recent analysis of adolescents with cystic fibrosis similarly identified an anxiety prevalence of 22% overall, 37 with higher prevalence in girls than boys.”
BackgroundBathgate, C. J., Muther, E., Georgiopoulos, A. M., et al. (2023) · Pediatric Pulmonology · doi:10.1002/ppul.26527 · Cited by 51 · see citing works
“been reported in pwCF, given that these studies were conducted before COVID pandemic.(13) This study represents a first step in systematically documenting healthcare provider observations on the positive and negative experiences of pwCF who have started ETI.”
MethodSelf-citationPediatric Consultation-Liaison Psychiatry: An Update and Review
Becker, J. E., Smith, J. R., & Hazen, E. P. (2020) · Psychosomatics · doi:10.1016/j.psym.2020.04.015 · Cited by 55 · see citing works
“[60] [61] [62] [63] For instance, the Cystic Fibrosis (CF) Foundation and European Cystic Fibrosis Society recently partnered to produce consensus guidelines on implementing developmentally-appropriate psychoeducation and screening for anxiety and depression in CF patients and their caregivers, as well as recommendati…”
BackgroundPiehler, L., Thalemann, R., Lehmann, C., Thee, S. A., Roehmel, J. F., Syunyaeva, Z., Stahl, M., Mall, M. A., & Graeber, S. Y. (2023) · Frontiers in Pharmacology · doi:10.3389/fphar.2023.1179208 · Cited by 53 · see citing works
“In adult patients with CF, symptoms of depression are observed in ~20% and symptoms of anxiety in ~30%, which is about 2-fold higher than in the general population (~10% and ~15%, respectively) (Martin et al., 2006; Goldbeck et al., 2010; Besier and Goldbeck, 2011; Ploessl et al., 2014; Quittner et al., 2014; Graziano…”
BackgroundResultA Roadmap to Emotional Health for Children and Families With Chronic Pediatric Conditions
Pickles, D. M., Lihn, S. L., Boat, T. F., & Lannon, C. (2020) · PEDIATRICS · doi:10.1542/peds.2019-1324 · Cited by 50 · see citing works
Lord, L., McKernon, D., Grzeskowiak, L. E., Kirsa, S. W., & Ilomäki, J. (2022) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-022-02307-w · Cited by 49 · see citing works
Current evidence and opportunities in child and adolescent public mental health: a research review
Fazel, M. S., & Soneson, E. (2023) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13889 · Cited by 58 · see citing works
Lanzkron, S., Sawicki, G. S., Hassell, K. L., Konstan, M. W., Liem, R. I., & McColley, S. A. (2018) · Journal of Clinical and Translational Science · doi:10.1017/cts.2018.338 · Cited by 49 · see citing works
“Depression and anxiety disorders among people with CF increases during adolescence [24, 37].”
BackgroundGraziano, S., Boldrini, F., Righelli, D., Milo, F., Lucidi, V., Quittner, A. L., & Tabarini, P. (2021) · Pediatric Pulmonology · doi:10.1002/ppul.25413 · Cited by 49 · see citing works
Self-citationManagement of neuropsychiatric symptoms in adults treated with elexacaftor/tezacaftor/ivacaftor
Baroud, E., Chaudhary, N., & Georgiopoulos, A. M. (2023) · Pediatric Pulmonology · doi:10.1002/ppul.26412 · Cited by 50 · see citing works
Fidika, A., Herle, M., & Goldbeck, L. (2014) · BMC Pulmonary Medicine · doi:10.1186/1471-2466-14-205 · Cited by 46 · see citing works
“According to the international TIDES study involving nine countries [13], 10% of adolescents and 19% of adults with CF reported elevated symptoms of depression.”
MethodO'Donovan, C., Painter, L., Lowe, B., Robinson, H., & Broadbent, E. (2015) · Cardiology in the Young · doi:10.1017/s1047951114002728 · Cited by 45 · see citing works
Hester, K. L. M., Newton, J. L., Rapley, T., & Soyza, A. D. (2018) · BMC Pulmonary Medicine · doi:10.1186/s12890-018-0633-5 · Cited by 45 · see citing works
“In cystic fibrosis, depression and anxiety rates are higher than in the general population, and therefore annual screening is recommended [20, 21].”
BackgroundGruet, M., SAYNOR, Z. L., Urquhart, D. S., & Radtke, T. (2021) · Journal of Cystic Fibrosis · doi:10.1016/j.jcf.2021.08.004 · Cited by 45 · see citing works
Faint, N. R., Staton, J. M., Stick, S. M., Foster, J. M., & Schultz, A. (2017) · Journal of Paediatrics and Child Health · doi:10.1111/jpc.13458 · Cited by 42 · see citing works
Ibrahim, H., Danish, H., Morrissey, D. J., Deasy, K. F., McCarthy, M. J. H., Dorgan, J., Fleming, C., Howlett, C., Twohig, S., Vagg, T., et al. (2023) · Frontiers in Pharmacology · doi:10.3389/fphar.2023.1156621 · Cited by 42 · see citing works
“, 2014), along with 22% of CF adolescents and 32% of CF adults experiencing anxiety (Quittner et al., 2014).”
BackgroundOrganization of Patient Management and Fungal Epidemiology in Cystic Fibrosis
Schwarz, C., Bouchara, J.-P., Buzina, W., Chrenková, V., Dmeńska, H., de la Pedrosa, E. G. G., Cantón, R., Fiscarelli, E. V., Govic, Y. L., Kondori, N., et al. (2017) · Mycopathologia · doi:10.1007/s11046-017-0205-x · Cited by 41 · see citing works
“[17], psychological symptoms were reported from 6088 patients with CF and 4102 parents.”
BackgroundRegulation of CFTR Biogenesis by the Proteostatic Network and Pharmacological Modulators
Estabrooks, S. K., & Brodsky, J. L. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21020452 · Cited by 40 · see citing works
“Finally, approximately one-quarter of all CF adults report suffering from depression or anxiety [22,23], indicating that this disease not only takes a physical toll upon those afflicted, but a psychological one as well.”
BackgroundThe fibrinolytic system: A new target for treatment of depression with psychedelics
Idell, R. D., Florova, G., Komissarov, A. A., Shetty, S., Girard, R., & Idell, S. (2017) · Medical Hypotheses · doi:10.1016/j.mehy.2017.01.013 · Cited by 40 · see citing works
“Additionally, patients with cystic fibrosis (CF) have been shown to have increased incidence of depression and anxiety [39].”
BackgroundMental Health screening in cystic fibrosis centres across Europe
Abbott, J., Havermans, T., Järvholm, S., Landau, E., Prins, Y., Smrekar, U., Staab, D., Verity, L., & Verkleij, M. (2018) · Journal of Cystic Fibrosis · doi:10.1016/j.jcf.2018.09.003 · Cited by 40 · see citing works
Self-citationKavalieratos, D., Georgiopoulos, A. M., Dhingra, L. K., Basile, M. J., Rabinowitz, E. C., Hempstead, S. E., Faro, A., & Dellon, E. P. (2020) · Journal of Palliative Medicine · doi:10.1089/jpm.2020.0311 · Cited by 41 · see citing works
“Caregiving brings countless rewards but also substantial emotional and financial tolls; thus, attention to caregiver needs is critical.(13,47) Caregiver concerns may include worries about the individual with CF, feeling overwhelmed or depressed, distress around medical decision making, inability to attend to one’s own…”
BackgroundDevelopment and evaluation of a palliative care curriculum for cystic fibrosis healthcare providers
Linnemann, R. W., O’Malley, P. J., Friedman, D., Georgiopoulos, A. M., Buxton, D., Altstein, L. L., Sicilian, L., Lapey, A., Sawicki, G. S., & Moskowitz, S. M. (2015) · Journal of Cystic Fibrosis · doi:10.1016/j.jcf.2015.03.005 · Cited by 40 · see citing works
“With this increased life expectancy [1], patients with CFmust now cope with a more chronic burden of symptoms and treatments, including distressing symptoms such as pain, dyspnea, cough, fatigue, insomnia, nausea, depression, and anxiety [2–4].”
BackgroundSmith, B. A., Georgiopoulos, A. M., Mueller, A., Abbott, J., Lomas, P., Aliaj, E., & Quittner, A. L. (2021) · Journal of Cystic Fibrosis · doi:10.1016/j.jcf.2021.08.027 · Cited by 40 · see citing works
“Depression and anxiety are two to four times more prevalent n people with CF (pwCF) than the general population, according o a study of 6088 pwCF ages 12 years through adulthood and 102 parent caregivers across nine countries [1] .”
BackgroundSelf-citationKramer‐Golinkoff, E., Camacho, A., Kramer, L., & Taylor‐Cousar, J. L. (2022) · Pediatric Pulmonology · doi:10.1002/ppul.25859 · Cited by 41 · see citing works
“Importantly, respondents were clear that beyond the burden of disease, as reported by others, the psychosocial impacts of living with CF for pwCF and for their caregivers are profound.(18) Furthermore, the psychological impact of the burden and worry that having CF has on daily life has been compounded by the differen…”
BackgroundLongitudinal Effects of Elexacaftor/Tezacaftor/Ivacaftor
Graziano, S., Boldrini, F., Pellicano, G. R., Milo, F., Majo, F., Cristiani, L., Montemitro, E., Alghisi, F., Bella, S., Cutrera, R., et al. (2023) · CHEST Journal · doi:10.1016/j.chest.2023.10.043 · Cited by 42 · see citing works
Self-citationPsychological resilience and intolerance of uncertainty in coping with cystic fibrosis
Mitmansgruber, H., Smrekar, U., Rabanser, B., Beck, T. N., Eder, J., & Ellemunter, H. (2015) · Journal of Cystic Fibrosis · doi:10.1016/j.jcf.2015.11.011 · Cited by 39 · see citing works
“For example, the TIDES-study with 6088 adolescents and adults across nine countries [15] found a prevalence of anxiety and depression that is 2–3 times that of community samples, whereas the UK subsample of this group (2065 patients, [4]) found rates comparable to the general population.”
MethodCaregiver burden and vocational participation among parents of adolescents with CF
Neri, L., Lucidi, V., Catastini, P., Colombo, C., & the LINFA Study Group (2015) · Pediatric Pulmonology · doi:10.1002/ppul.23352 · Cited by 41 · see citing works
“However, the generizability of results is supported by the consistency of the clinical characteristics of our patients with previous studies of the Italian CF pediatric population.(3,36) In conclusion, our study demonstrates that caregiving burden is a relevant and a frequent issue among parents of children with CF.”
ResultSelf-citationPsychosocial well-being in Dutch adults with disorders of sex development
de Neve-Enthoven, N. G. M., Callens, N., van Kuyk, M., van Kuppenveld, J. H., Drop, S. L. S., Cohen‐Kettenis, P. T., & Dessens, A. B. (2016) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2016.03.005 · Cited by 39 · see citing works
Maintaining mental health and function for the long run in cystic fibrosis
Smith, B. A., Georgiopoulos, A. M., & Quittner, A. L. (2016) · Pediatric Pulmonology · doi:10.1002/ppul.23522 · Cited by 39 · see citing works
“A recent multinational study across nine countries, including the US, measured symptoms of depression and anxiety in over 6,000 adolescents and adults with CF and 4,200 parent caregivers.(9) The results indicated that both individuals with CF and parents had a prevalence of psychological distress 2–3 times higher than…”
BackgroundResultSelf-citationVerkleij, M., de Winter, D., Hurley, M. A., & Abbott, J. (2018) · Journal of Cystic Fibrosis · doi:10.1016/j.jcf.2018.02.005 · Cited by 37 · see citing works
Self-citationGraziano, S., Spanò, B., Majo, F., Righelli, D., Vincenzina, L., Quittner, A., & Tabarini, P. (2020) · Respiratory Medicine · doi:10.1016/j.rmed.2020.106147 · Cited by 38 · see citing works
Self-citationIntegrated Behavioral Health Care in Pediatric Subspecialty Clinics
Samsel, C. B., Ribeiro, M., Ibeziako, P. I., & DeMaso, D. R. (2017) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2017.06.004 · Cited by 37 · see citing works
Catastini, P., Di Marco, S., Furriolo, M., Genovese, C., Grande, A., Iacinti, E., Iusco, D. R., Nobili, R. M. V., Pescini, R., Ragni, R., et al. (2016) · Pediatric Pulmonology · doi:10.1002/ppul.23566 · Cited by 36 · see citing works
“international study TIDES(6) as well as those of the international study TIDES itself.(5) These results were not confirmed with regard to the depression levels.”
ResultSelf-citationO'Hayer, C. V., O'Loughlin, C. M., Nurse, C. N., Smith, P. J., & Stephen, M. J. (2021) · Journal of Cystic Fibrosis · doi:10.1016/j.jcf.2020.11.013 · Cited by 34 · see citing works
Fathers’ experiences of their child’s life-limiting condition: An attachment narrative perspective
Bailey-Pearce, O., Stedmon, J., Dallos, R., et al. (2017) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104517730115 · Cited by 35 · see citing works
“Research has shown that children with a life-limiting illness and their parents are more likely to experience mental health difficulties than community samples (Quittner et al., 2014).”
Cronly, J., Duff, A. J. A., Riekert, K. A., Perry, I. J., Fitzgerald, T., Horgan, A. M., Lehane, E. A., Howe, B., Chróinín, M. N., & Savage, E. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-019305 · Cited by 35 · see citing works
“In the TIDES international study, all data collection was paper-based.(4) Therefore, our study draws attention to the potential of online screening for depression and”
BackgroundMethodInfluentialSelf-citationWolff, J., Thomas, S. A., Hood, E., Bettis, A. H., Rizzo, C. J., & Liu, R. T. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.08.075 · Cited by 28 · see citing works
“, 2014), and parents and teens with chronic illness show concordance with regard to depression symptoms (Quittner et al., 2014).”
BackgroundA New Ethical Framework for Assessing the Unique Challenges of Fetal Therapy Trials
Hendriks, S., Grady, C., Wasserman, D., Wendler, D. S., Bianchi, D. W., & Berkman, B. E. (2021) · The American Journal of Bioethics · doi:10.1080/15265161.2020.1867932 · Cited by 35 · see citing works
Olveira, C., Solé, A., Girón, R. M., Quintana‐Gallego, E., Mondejar, P., Baranda, F., Alvarez, A., Prados, C., Rodríguez-González, J., Labarga, I. H., et al. (2016) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2016.02.002 · Cited by 34 · see citing works
“In patients with CF, these symptoms have been associated with worse adherence [12–19], worse pulmonary function [9,11,14,20,21], increased hospitalizations and health care costs [16,17,19], which implies that systematic screening should”
InfluentialSelf-citationPrevalence of severe fatigue among adults with cystic fibrosis: A single center study
der Vlist, M. M. N.-V., Burghard, M., Hulzebos, E. H. J., Doeleman, W. R., Heijerman, H. G. M., van der Ent, C. K., & Nijhof, S. L. (2018) · Journal of Cystic Fibrosis · doi:10.1016/j.jcf.2018.03.003 · Cited by 34 · see citing works
“For example, depressive symptoms should clearly be taken into account, given that these symptoms are frequently correlated with fatigue in other patient populations, and given their increased prevalence among patients with CF [12].”
Dellon, E. P., Helms, S. W., Hailey, C. E., et al. (2018) · Pediatric Pulmonology · doi:10.1002/ppul.24073 · Cited by 34 · see citing works
“Consensus recommendations are available to guide assessment and treatment of anxiety and depression.(15) Prompt identification and treatment of both physical and emotional symptoms positively impacts adherence to therapies and quality of life.”
Backgroundvan den Hoven, A. T., Bons, L. R., Dykgraaf, R., Dessens, A. B., Pastoor, H., de Graaff, L. C. G., Metselaar, M., Kneppers-Swets, A., Kardys, I., Mijnarends, H., et al. (2020) · Clinical Endocrinology · doi:10.1111/cen.14166 · Cited by 34 · see citing works
The impact of rare diseases on the quality of life in paediatric patients: current status
Dumbuya, J. S., Zeng, C., Deng, L., Li, Y., Chen, X., Ahmad, B., & Lü, J. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1531583 · Cited by 38 · see citing works
Overcoming psychosocial challenges in cystic fibrosis: Promoting resilience
Muther, E., Polineni, D., & Sawicki, G. S. (2018) · Pediatric Pulmonology · doi:10.1002/ppul.24127 · Cited by 32 · see citing works
“Multiple studies of adherence rates in CF have identified adolescence and young adulthood as the periods of lowest adherence.(9,10) Adolescence is also a period of heightened developmental challenges, as youth are normally expected to develop independence from their parents.”
BackgroundWestcott, K. A., Wilkins, F. M., Chancellor, A., et al. (2021) · Future Healthcare Journal · doi:10.7861/fhj.2020-0205 · Cited by 32 · see citing works
Evaluation of quality of life predictors in adolescents and young adults with cystic fibrosis
Tomaszek, L., Dębska, G., Cepuch, G., Kulpa, M., Pawlik, L., & Broniatowska, E. (2018) · Heart & Lung · doi:10.1016/j.hrtlng.2018.08.003 · Cited by 32 · see citing works
Intestinal dysbiosis and inflammation in cystic fibrosis impacts gut and multi-organ axes
Wrigley-Carr, H., van Dorst, J. M., & Ooi, C. Y. (2022) · Medicine in Microecology · doi:10.1016/j.medmic.2022.100057 · Cited by 31 · see citing works
Cystic Fibrosis Transitions of Care
Okumura, M. J., & Kleinhenz, M. E. (2015) · Clinics in Chest Medicine · doi:10.1016/j.ccm.2015.11.007 · Cited by 31 · see citing works
“Toguideclinical practice, research, and policy, we then discuss the role of quality improvement initiatives as ameans to improve transition of care for patients with CF.”
BackgroundInfluentialGündoğdu, Ü., Fiş, N. P., Eralp, E. E., & Karadag, B. T. (2019) · Pediatric Pulmonology · doi:10.1002/ppul.24492 · Cited by 31 · see citing works
Friedman, D., Linnemann, R. W., Altstein, L. L., Islam, S., Bach, K., Lamb, C., Volpe, J., Doolittle, C., John, A. S., O’Malley, P. J., et al. (2017) · Journal of Cystic Fibrosis · doi:10.1016/j.jcf.2017.02.011 · Cited by 30 · see citing works
Exercise as a therapeutic intervention for people with cystic fibrosis
Ward, N., Stiller, K. R., & Holland, A. E. (2019) · Expert Review of Respiratory Medicine · doi:10.1080/17476348.2019.1598861 · Cited by 31 · see citing works
“Adolescents and adults with CF have worse HRQOL and higher rates of symptomatic depression and anxiety compared to their age-matched peers [58,59].”
BackgroundPrevalence of unmet palliative care needs in adults with cystic fibrosis
Trandel, E. T., Pilewski, J. M., Dellon, E. P., Jeong, K., Yabes, J. G., Moreines, L. T., Arnold, R. M., Hoydich, Z., & Kavalieratos, D. (2019) · Journal of Cystic Fibrosis · doi:10.1016/j.jcf.2019.11.010 · Cited by 28 · see citing works
Patient Science: Citizen Science Involving Chronically Ill People as Co-Researchers
Heyen, N. B., Gardecki, J., Eidt‐Koch, D., Schlangen, M., Pauly, S., Eickmeier, O., Wagner, T. O. F., & Bratan, T. (2022) · Journal of Participatory Research Methods · doi:10.35844/001c.35634 · Cited by 30 · see citing works
Wessels-Bakker, M. J., van de Graaf, E. A., Erp, J. M. K., Heijerman, H. G. M., Cahn, W., & Schappin, R. (2021) · Journal of Clinical Nursing · doi:10.1111/jocn.15931 · Cited by 27 · see citing works
Thabrew, H., McDowell, H., Given, K., & Murrell, K. (2017) · Global Pediatric Health · doi:10.1177/2333794x17690314 · Cited by 28 · see citing works
Novel therapeutic approaches for the management of cystic fibrosis
Jaques, R., Shakeel, A., & Hoyle, C. (2020) · Multidisciplinary Respiratory Medicine · doi:10.4081/mrm.2020.690 · Cited by 61 · see citing works
“symptoms of depression and anxiety in both individuals with CF and their caregivers [50,51].”
BackgroundAnxiety in Children with Cystic Fibrosis and Their Parents: A Systematic Review
Kimball, H., Douglas, T. A., Sanders, M. R., & Cobham, V. E. (2021) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-021-00345-5 · Cited by 28 · see citing works
Guta, M. T., Tekalign, T., Awoke, N., Fite, R. O., Dendir, G., & Lenjebo, T. L. (2021) · International Journal of Chronic Diseases · doi:10.1155/2021/6708865 · Cited by 27 · see citing works
“All of the included studies were cross-sectional studies, and the sample size ranged from 22 [28] to 2042 [22].”
BackgroundGinsburg, D. K., Salinas, D. B., Cosanella, T. M., Wee, C. P., Saeed, M. M., Keens, T. G., & Gold, J. I. (2022) · Journal of Cystic Fibrosis · doi:10.1016/j.jcf.2022.12.002 · Cited by 28 · see citing works
Askew, K., Bamford, J., Hudson, N. A., et al. (2017) · Clinical Medicine · doi:10.7861/clinmedicine.17-2-121 · Cited by 28 · see citing works
Yoga Therapy in Children with Cystic Fibrosis Decreases Immediate Anxiety and Joint Pain
McNamara, C., Johnson, M., Read, L., Velden, H. V., Thygeson, M. V., Liu, M., Gandrud, L. M., & McNamara, J. (2016) · Evidence-based Complementary and Alternative Medicine · doi:10.1155/2016/9429504 · Cited by 27 · see citing works
“These factors may contribute to decreased quality of life as well as decreased adherence to treatments [3, 4, 10, 27].”
BackgroundCox, N. S., Eldridge, B. J., Rawlings, S. L., Dreger, J., Corda, J., Hauser, J., Button, B., Bishop, J., Nichols, A., Middleton, A., et al. (2019) · BMC Pulmonary Medicine · doi:10.1186/s12890-019-0942-3 · Cited by 27 · see citing works
Promoting emotional wellness in children with CF, part II: Mental health assessment and intervention
Georgiopoulos, A. M., Christon, L., Filigno, S. S., Mueller, A., Prieur, M. G., Boat, T. F., & Smith, B. A. (2020) · Pediatric Pulmonology · doi:10.1002/ppul.24977 · Cited by 26 · see citing works
Collaço, N., Legg, J. P., Day, M., Culliford, D. J., Campion, A., West, C., & Darlington, A. (2021) · Pediatric Pulmonology · doi:10.1002/ppul.25537 · Cited by 27 · see citing works
“Research has demonstrated that individuals with CF and their families experience high rates of clinically significant symptoms of depression and anxiety compared with community samples.(17,18) There is also increasing evidence of the significant psychological impact of the COVID‐19 pandemic on individuals with CF.”
BackgroundAncel, J., Launois, C., Perotin, J., Ravoninjatovo, B., Mulette, P., Hagenburg, J., Malet, J., Griffon, M., Carré, S., Lebargy, F., et al. (2022) · Healthcare · doi:10.3390/healthcare10071351 · Cited by 27 · see citing works
“Current guidelines recommend an annual screening of these psychological disorders [29].”
BackgroundGrossoehme, D. H., Szczesniak, R. D., Mrug, S., Dimitriou, S. M., Marshall, A., & McPhail, G. L. (2016) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsw024 · Cited by 27 · see citing works
Verkleij, M., Georgiopoulos, A. M., & Friedman, D. (2021) · Internet Interventions · doi:10.1016/j.invent.2021.100372 · Cited by 26 · see citing works
“Moreover, untreated depression and anxiety in people with CF were found to have negative consequences for health-related quality of life (HrQoL), adherence, medical outcomes and healthcare costs (Quittner et al., 2014; Smith et al., 2010; Verkleij et al., 2018).”
BackgroundThe feasibility of home monitoring of young people with cystic fibrosis: results from CLIMB-CF
Edmondson, C., Westrupp, N., Seddon, P., Olden, C., Wallis, C., Dawson, C., Brodlie, M., Baxter, F., McCormick, J., MacFarlane, S., et al. (2022) · Journal of Cystic Fibrosis · doi:10.1016/j.jcf.2021.09.018 · Cited by 26 · see citing works
- Authors
- Quittner, A. L., Goldbeck, L., Abbott, J., Duff, A., Lambrecht, P., Solé, A., Tibosch, M. M., Bergsten Brucefors, A., Yüksel, H., Catastini, P., Blackwell, L., & Barker, D.
- Affiliations
- University of Miami (US)
- University Hospital Ulm (DE)
- University of Lancashire (GB)
- Leeds Teaching Hospitals NHS Trust (GB)
- Université Libre de Bruxelles (BE)
- Radboud University Nijmegen (NL)
- Manisa Celal Bayar University (TR)
- Meyer Children's Hospital (IT)
- Boston Children's Hospital (US)
- Brown University (US)
- Corresponding author
- Quittner, Alexandra L
- ORCID
- Venue
- Thorax
- Publisher
- BMJ
- Published
- 2014-09-21
- Volume
- 69
- Issue
- 12
- Pages
- 1090-1097
- ISSN
- 0040-6376 (ISSN-L)
- 1468-3296
- OpenAlex
- W2107382266
- Cited by
- 524
- References
- 42
- Citations by year
- 2026: 29 · 2025: 37 · 2024: 42 · 2023: 60 · 2022: 74 · 2021: 65 · 2020: 50 · 2019: 33 · 2018: 44 · 2017: 32 · 2016: 24 · 2015: 31 · 2014: 2
- FWCI
- 23.76
- Type
- journal article
- Language
- en
- Open access
- green
- thorax.bmj.com
- Locations
- Thorax (publishedVersion)
- PubMed (publishedVersion)
- CLOK (University of Central Lancashire) (acceptedVersion)
- HighWire Press Open Archive (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cystic Fibrosis Research Advances
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- cystic fibrosis, depression, anxiety, parental caregivers, caregiver burden, adolescents, adults, comorbidities, cross-national comparison, psychological screening
- MeSH terms
- Adolescent, Adult, Anxiety, Child, Cystic Fibrosis, Depression, Europe, Family Health, Female, Humans, Male, Middle Aged, Parents, Psychiatric Status Rating Scales, Risk Factors, Turkey, United States, Comorbidity, Prevalence, Caregivers, Young Adult
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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