Young Adults with CF Troubled by Depression and Often Ignore Treatments, Danish Study Reports

Young adults with cystic fibrosis (CF) are particularly vulnerable to depression. As a consequence, these patients may have low rates of adherence to treatments and a severely impaired quality of life, researchers report.

The study, “Associations between adherence, depressive symptoms and health-related quality of life in young adults with cystic fibrosis,” was published in the journal Springer Plus.

Prognosis for people with this genetic and chronic disease has significantly improved in the last years, and adults with CF may now live independent and balanced lives. Despite this, many CF patients find integrating their prescribed treatments into their lives a difficult challenge. In fact, recent reports found poor treatment adherence in pulmonary medication and use of health-care facilities, and a high prevalence of depression in certain CF populations.

Now, researchers examined the interplay among treatment adherence, symptoms of depression, and health-related quality of life (HRQoL) in a population of young adults with CF in Denmark.

To this end, the team gave three standardized questionnaires to 67 patients with CF, ages 18 to 30: the Morisky Medication Adherence Scale, Major Depression Inventory, and The Cystic Fibrosis Questionnaire-Revised-Teen/Adult version.

The Morisky Medication Adherence Scale is a validated, self-reporting questionnaire that measures adherence to prescribed medications. It includes specific medication-taking behaviors, and identifies common barriers to poor adherence. The Major Depression Inventory measures depressive symptoms, and the Cystic Fibrosis Questionnaire-Revised-Teen/Adult version is a well-validated, disease-specific HRQoL instrument for CF patients age 14 and older.

Researchers found that a significant fraction of the young population (84%) were either employed or enrolled in an education program; another 3% were unemployed and 13% unable to work for health reasons.

More importantly, 74% of respondents reported low or poor adherence to prescribed medications, and 32.8% (corresponding to one-third of the participants) reported symptoms of depression. HRQoL scores were low, particularly those associated with “vitality” and “treatment burden.” Low HRQoL scores also associated with symptoms of depression, and patients showing high depression symptom scores also tended to report low adherence to CF treatments.

These results, in a Danish cohort of young adults with CF, show that the adherence to prescribed treatment is low, and symptoms of depression are prevalent, impairing quality of life. These findings support recent recommendations for annual screening of depression and anxiety in CF patients (12 years and older), and highlight the need for a continuous attention of the mental status in young adults with CF.

Overall, the researchers wrote, “our findings suggest that treating depression is an important target for intervention, and may have positive effects on lung function and other health outcomes.”