A Cross-Sectional Study of the Psychological Needs of Adults Living with Cystic Fibrosis

<div><p>Background</p><p>Depression and anxiety are prevalent in people with cystic fibrosis (CF), yet psychological services are rarely accessible in CF clinics. This cross-sectional single center study reports on a psychological needs assessment of people with CF.</p><p>Methods</p><p>We asked adults attending a CF clinic, without integrated psychological services, to complete a psychological needs assessment survey that included items on: a) past access to psychological services (via a CF referral service), b) concerns relevant to discuss with a psychologist, and c) their likelihood of accessing psychological services if available at the CF clinic, and standardized measures of depression (CES-D) and anxiety (GAD-7).</p><p>Results</p><p>We enrolled 49 participants and 45 (91.8%) completed the survey. Forty percent reported elevated symptoms of depression and 13% had elevated anxiety. A majority of individuals (72.2% and 83.3%, respectively) indicated they would be likely to use psychological services, if available at the clinic. Concerns considered most relevant to discuss with a psychologist were: 1) worries (51.1%), 2) mood (44.4%), 3) life stress (46.6%), 4) adjustment to CF (42.2%), 5) life transitions (42.2%) and 6) quality of life (42.2%).</p><p>Conclusions</p><p>This study highlights the rationale for screening adults with CF for depression and anxiety, and to facilitate provision of psychological services and preventative mental health interventions as an integral component of multi-disciplinary CF care.</p></div

Past access to psychological services as part of CF care and likelihood of accessing psychological services if made available.

<p><i>Note</i>: n = 45 participants completed the CES-D and n = 44 completed the GAD7).</p><p>*P-values displayed are unadjusted. None of the adjusted (Holm’s) p-values were significant.</p><p>In bold: p-values for which effect sizes (Phi coefficient) were moderate (≥ 0.30).</p><p>^† Responses to this item were collapsed into two groups (‘Never or Rarely’ and ‘Occasionally or Often’) given the distribution of the data.</p><p>^β Responses to this item were collapsed into two groups (‘Likely’/ ‘Unlikely’) given the distribution of the data. Data was missing for one participant on this item.</p><p>Past access to psychological services as part of CF care and likelihood of accessing psychological services if made available.</p

Characteristics of study participants (n = 45)^*.

<p>*Unless indicated otherwise</p><p>Characteristics of study participants (n = 45)^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0127944#t001fn001" target="_blank">*</a>}.</p

Pulmonary Exacerbations and Hospitalizations by Treatment Group - 24 Week Treatment Period.

<p>Pulmonary Exacerbations and Hospitalizations by Treatment Group - 24 Week Treatment Period.</p

Trial Profile.

<p>Trial Profile.</p

Changes from Baseline in FEV1 Over the 48-Week Study.

<p>Blue dashed line = placebo-treated patients. Black solid line = itraconazole-treated patients. 95% confidence intervals are indicated by the error bars around the mean values.</p

Time to First Pulmonary Exacerbation Requiring Oral or Intravenous Antibiotics.

<p>Blue dashed line = placebo-treated patients. Black solid line = itraconazole-treated patients. The median time to first exacerbation was 77 days for the itraconazole group and 134 days for the placebo group, log-rank P = 0.35. Hash marks = censored observations.</p

Adverse Events.

<p>Adverse Events.</p

Baseline Characteristics of the Randomized Patients.

<p>Baseline Characteristics of the Randomized Patients.</p