Chest
Volume 132, Issue 1, July 2007, Pages 231-237
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ORIGINAL RESEARCH
CYSTIC FIBROSIS
The Association Between Depression, Lung Function, and Health-Related Quality of Life Among Adults With Cystic Fibrosis

https://doi.org/10.1378/chest.06-2474Get rights and content

Background:

More than 40% of people born with cystic fibrosis (CF) now reach adulthood. Greater attention is being focused on improving their health-related quality of life (HRQoL). While markers of disease severity such as lung function are only modestly associated with HRQoL, in other chronic illnesses depression is an important correlate. The objective of this study was to evaluate the relationships among lung function (ie, FEV1 percent predicted), depressive symptoms, and HRQoL among adults with CF.

Methods:

Seventy-six adults with CF completed a mail-based survey. The Beck Depression Inventory and the Cystic Fibrosis Questionnaire were used to assess depressive symptoms and HRQoL, respectively. Values for FEV1 percent predicted were abstracted from the medical record.

Results:

Thirty percent of participants screened positive for depressive symptoms. Depressive symptoms and lung function were inversely correlated (rho = −0.25; p < .05). Correlations between depressive symptoms and HRQoL were maintained after stratifying by lung function. In the absence of depressive symptoms, those patients with good lung function (ie, FEV1, > 70% predicted) reported better physical HRQoL than those with poor lung function. Participants with both depressive symptoms and poor lung function reported significantly worse HRQoL on all domains than participants without depressive symptoms regardless of lung function status.

Conclusions:

Depressive symptoms are prevalent among adults with CF and are associated with poorer HRQoL even after controlling for lung function. These results suggest that screening for and treating depression is important and may potentially improve HRQoL among patients with CF.

Section snippets

Materials and Methods

This was a cross-sectional study that was conducted from April 2002 to November 2003. Adults ≥ 18 years of age were eligible to be included if they had a confirmed diagnosis of CF, had been seen in the clinic previously, and were scheduled for an outpatient appointment. A recruiter telephoned the patient, explained the study, assessed eligibility, and obtained verbal consent to mail the study materials. Participants completed the questionnaires at home and mailed back the consent form and

Results

One hundred thirty-three patients met the study eligibility requirements. Of these, 109 patients (82%) verbally consented, 11 (8%) refused consent, 7 (5%) were unable to be contacted, and 6 (5%) died before being contacted. Of the 109 participants, 80 (73%) returned the survey and 1 (1%) died before completing the survey. Two participants who returned completed surveys failed to return a consent form, one person had missing lung function data, and one person had missing depression data; they

Discussion

Consistent with previous studies,178 our study found that depressive symptoms are common among adults with CF, with 30% of participants exhibiting signs of depressive symptoms and 11% of participants screening positive for moderate-to-severe levels of depression. Only 13% of those participants who screened positively for moderate-to-severe levels of depressive symptoms were currently receiving treatment, suggesting that depression may be underdiagnosed and untreated in this population. Although

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    This research was supported by National Institute of Diabetes and Digestive and Kidney Disease grant 61135 and National Heart, Lung, and Blood Institute grant 63333.

    The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

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