The DOI matches its Crossref record; 45 of the 45 references it cites were found in a registry or an index; 7 of the 31 sources its claims cite were checked for support.
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
77 Own result · 12 No full text of the sources · 7 Own interpretation · 5 Own method · 4 Partly supported · 4 Sources not found · 1 Supported so far · 1 No basis given · accuracy not yet measured
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“rates of anxiety from 30% to 33%.”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > Why read on?
What the sources say
- Partly supportedcites [8] Havermans, 2008, Quality of life in patients with Cystic Fibrosis: association with anxiety and depression, J Cyst Fibros sourceExperimental — accuracy not yet measured
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)
- Supportedcites [10] Yohannes, 2012, Relationship between anxiety, depression, and quality of life in adult patients with cystic fibrosis, Respir Care source
The Introduction reports that 30% of adults with cystic fibrosis in an earlier study scored with anxiety symptoms. The paper’s Anxiety in Adult CF Subjects section reports anxiety symptoms in 33% of its own adult sample. Page numbers were not provided in our copy. (LLM, conf=0.94)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Instead, the vast majority of items on the HADS-D measured anhedonia (72%), which represents lack of enjoyment and pleasure in activities.36”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > DISCUSSION
What the sources say
- Partly supportedcites [36] American Psychiatric Association, 2013 sourceExperimental — accuracy not yet measured
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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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).”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Prevalence of symptoms of anxiety · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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).”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Prevalence of symptoms of anxiety · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Elevated symptoms of depression were found in 10% of adolescents, 19% of adults, 37% of mothers and 31% of fathers.”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Participants reporting elevated anxiety were more likely to report depression (ORs: adolescents=14.97,adults=13.64,mothers=15.52,fathers=9.20).”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Participants reporting elevated anxiety were more likely to report depression (ORs: adolescents=14.97,adults=13.64,mothers=15.52,fathers=9.20).”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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).”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Prevalence of symptoms of anxiety · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Participants reporting elevated anxiety were more likely to report depression (ORs: adolescents=14.97,adults=13.64,mothers=15.52,fathers=9.20).”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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).”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Prevalence of symptoms of anxiety · plain
- It may state two separate claims as one. 12
- Probably not a substantial claim. 13
- The quote only partly states this claim. 2
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“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”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > Why read on?
What the sources say
- Not checked — no full text of the sourcecites [7] Smith, 2010, Depressive symptoms in children with cystic fibrosis and parents and its effects on adherence to airway clearance, Pediatr Pulmonol source
- Partly supportedcites [14] Grenard, 2011, Depression and medication adherence in the treatment of chronic diseases in the United States: a meta-analysis, J Gen Intern Med sourceExperimental — accuracy not yet measured
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)
- Supportedcites [10] Yohannes, 2012, Relationship between anxiety, depression, and quality of life in adult patients with cystic fibrosis, Respir Care source
The citation to this paper is attached to decreased health-related quality of life, not to the sentence’s separate claims about adherence, hospitalisations, or costs. The Discussion reports that anxiety and depression in adults with CF were associated with impaired quality of life; it does not establish a causal direction. (LLM, conf=0.92)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Among parent caregivers, elevations in psychological distress have also been found, with depression ranging from 20% to 35%.”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > Why read on?
What the sources say
- Not checked — no full text of the sourcecites [7] Smith, 2010, Depressive symptoms in children with cystic fibrosis and parents and its effects on adherence to airway clearance, Pediatr Pulmonol source
- Not checked — no full text of the sourcecites [11] Latchford, 2013, Screening for depression in a single CF centre, J Cyst Fibros source
- Supportedcites [12] Besier, 2011, Anxiety, depression, and life satisfaction in parents caring for children with cystic fibrosis, Pediatr Pulmonol source
The Pediatric Pulmonology introductory passage reports high psychological distress among parents caring for children with cystic fibrosis and elevated depressive symptoms in 23% of fathers and 35% of mothers, consistent with the approximate 20%–35% range. The “Depressive symptoms in parents” section cautions that prevalence depends on the screening cutoff used; these figures describe elevated symptoms, not clinical diagnoses. Page numbers are unavailable in our copy. (LLM, conf=0.84)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“For adults with CF, rates of depression have ranged from 13% to 30%”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > Why read on?
What the sources say
- Partly supportedcites [8] Havermans, 2008, Quality of life in patients with Cystic Fibrosis: association with anxiety and depression, J Cyst Fibros sourceExperimental — accuracy not yet measured
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)
- Not checked — no full text of the sourcecites [9] Riekert, 2007, The association between depression, lung function, and health-related quality of life among adults with cystic fibrosis, Chest source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Partly supported
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“CES-D=52%”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > Prevalence of symptoms of depression
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > Prevalence of symptoms of anxiety
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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).”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > Prevalence of symptoms of depression
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Analyses by country indicated high rates of anxiety among patients (mean 30%), with moderate variability across countries (14%-35%; Turkey falls within this range).”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > Prevalence of symptoms of anxiety
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Rates of anxiety were also elevated in patients and caregivers, with 30% of patients and 36%-48% of parents above the clinical cut-off.”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“comparisons indicated that the HADS-D underestimated symptoms of depression by a factor of two.”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > DISCUSSION
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
In the paper
“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.”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > INTRODUCTION
What the sources say
- Not matchedcites [1][2][3]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
- Not matched
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Studies evaluating depression and anxiety in patients with CF have generally found a high prevalence of psychological distress.”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > INTRODUCTION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“Cystic fibrosis (CF) is the most common genetic, life-limiting chronic disease among Caucasian populations”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > INTRODUCTION
What the sources say
- Not checked — no full text of the sourcecites [4] Sawicki, 2011, Longitudinal assessment of health-related quality of life in an observational cohort of patients with cystic fibrosis, Pediatr Pulmonol source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > Nesting of participants within country
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Because few participant responses were missing, this was unlikely to significantly bias the results, and we opted to use complete cases in all analyses.”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > Missing data
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“It has extensive reliability and validity data, and was designed specifically for patients with chronic medical conditions (i.e., removal of somatic items).”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > Hospital Anxiety and Depression Scale
What the sources say
- Not checked — no full text of the sourcecites [18] Zigmond, 1983, The hospital anxiety and depression scale, Acta Psychiatric Scand source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“The CES-D is a well-established self-report measure of depressive symptomatology for community samples.”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > Center for Epidemiologic Studies-Depression scale
What the sources say
- Not checked — no full text of the sourcecites [19] Radloff, 1991, The use of the Center for Epidemiologic Studies Depression Scale in adolescents and young adults, J Youth Adolesc source
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“requires a treatment regimen that takes between 2 and 4 h per day.”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > INTRODUCTION
What the sources say
- Not checked — no full text of the sourcecites [4] Sawicki, 2011, Longitudinal assessment of health-related quality of life in an observational cohort of patients with cystic fibrosis, Pediatr Pulmonol source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“It has 20 items measuring symptoms of depression that reflect diagnostic criteria on the DSM-IV and has correlated well with diagnostic interviews.”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > Center for Epidemiologic Studies-Depression scale
What the sources say
- Not checked — no full text of the sourcecites [19] Radloff, 1991, The use of the Center for Epidemiologic Studies Depression Scale in adolescents and young adults, J Youth Adolesc source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Study protocols were approved by national and local ethics committees or institutional review boards at all CF centres.”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > METHODS Procedure
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“37% of mothers and 31% of fathers reported clinically elevated depression, which is three times the rate in community samples.23 24”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > DISCUSSION
What the sources say
- Not checked — no full text of the sourcecites [23] Martin, 2006, Validity of the brief patient health questionnaire mood scale (PHQ-9) in the general population, Gen Hosp Psychiatry source
- Not checked — no full text of the sourcecites [24] Pignone, 2002, Screening for depression in adults: a summary of the evidence for the US Preventive Services Task Force, Ann Intern Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“it is possible that this sample is not representative of the larger international population.”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > Limitations and future directions
hedgedn = 3- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > DISCUSSION
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“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.”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > DISCUSSION
What the sources say
- Not matchedcites [33][34][35]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These results highlight the importance of measuring and treating mental health issues in patients and families coping with serious, chronic illnesses.”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > Limitations and future directions
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
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?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“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]
The cited source says what the claim attributes to it.
In the citing paper
“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]
The cited source says what the claim attributes to it.
In the citing paper
“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]
The cited source says what the claim attributes to it.
In the citing paper
“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 cited source says what the claim attributes to it.
In the citing paper
“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]
The cited source says what the claim attributes to it.
In the citing paper
“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]
The cited source says what the claim attributes to it.
In the citing paper
“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]
The cited source says what the claim attributes to it.
In the citing paper
“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.”
The cited source says what the claim attributes to it.
In the citing paper
“While people with CF experience depression and anxiety at a rate 2-3 × greater than the general population [20]”
From Real-world safety and effectiveness of elexacaftor/tezacaftor/ivacaftor in people with cystic fibrosis: Interim results of a long-term registry-based study (2023) · cites this paper as [20]
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.
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > Predictors of depression and 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.”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > Limitations and future directions
“| 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 | | | |”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > Abstract
“adolescents whose parents reported depression were more likely to be elevated on depression (OR=2.32)”
§ Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries > Concordance between parent and adolescent depression and anxiety
“adolescents were 2.39 times more likely be above the cut-off for depression if at least one of their parents had elevated symptoms”
Citations
Cites
Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013) · doi:10.1176/appi.books.9780890425596 · Cited by 116,369
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,845
The Hospital Anxiety and Depression Scale
Zigmond, A. S., & Snaith, R. P. (1983) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1983.tb09716.x · Cited by 47,139
Standards of medical care in diabetes—2014
American Diabetes Association (2014) · Diabetes Care · doi:10.2337/dc14-s014 · Cited by 4,572
Standards of medical care in diabetes—2013
American Diabetes Association (2013) · Diabetes Care · doi:10.2337/dc13-s011 · Cited by 4,369
Depression, chronic diseases, and decrements in health: results from the World Health Surveys
Moussavi, S., Chatterji, S., Verdes, E., Tandon, A., Patel, V., & Ustun, B. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61415-9 · Cited by 4,070
Basevi, V., Mario, S. D., Morciano, C., Nonino, F., & Magrini, N. (2011) · Diabetes Care · doi:10.2337/dc11-0174 · Cited by 3,058
Herrmann, C. (1997) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(96)00216-4 · Cited by 2,885
The use of the Center for Epidemiologic Studies Depression Scale in adolescents and young adults
Radloff, L. S. (1991) · Journal of Youth and Adolescence · doi:10.1007/bf01537606 · Cited by 1,997
Prevalence and correlates of depression, anxiety, and suicidality among university students
Eisenberg, D., Gollust, S. E., Golberstein, E., & Hefner, J. L. (2007) · American Journal of Orthopsychiatry · doi:10.1037/0002-9432.77.4.534 · Cited by 1,592
Research works printed but not linked: 1
- Quittner, 2012, Treatment adherence in adolescents with cystic fibrosis, 77
Cited by
Sorted by citations
Elborn, J. S. (2016) · The Lancet · doi:10.1016/s0140-6736(16)00576-6 · Cited by 1,805
The future of cystic fibrosis care: a global perspective
Bell, S. C., Mall, M. A., Gutierrez, H., Macek, M., Madge, S. L., Davies, J. C., Burgel, P., Tullis, E., Castaños, C., Castellani, C., et al. (2019) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(19)30337-6 · Cited by 1,081
ECFS best practice guidelines: the 2018 revision
Castellani, C., Duff, A. J. A., Bell, S. C., Heijerman, H. G. M., Munck, A., Ratjen, F., Sermet-Gaudelus, I., Southern, K. W., Barben, J., Flume, P. A., et al. (2018) · Journal of Cystic Fibrosis · doi:10.1016/j.jcf.2018.02.006 · Cited by 765
Self-citationShteinberg, M., Haq, I. J., Polineni, D., & Davies, J. C. (2021) · The Lancet · doi:10.1016/s0140-6736(20)32542-3 · Cited by 682
Ratjen, F. A., Bell, S. C., Rowe, S. M., Goss, C. H., Quittner, A. L., & Bush, A. (2015) · Nature Reviews Disease Primers · doi:10.1038/nrdp.2015.10 · Cited by 575
Self-citation
Metadata
- 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
- Health Sciences › Medicine › Psychiatry and Mental health › 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
About these checks
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.
A language model drew the claims from the paper on 2026-10-11, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-11 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
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