In Children With CF, Parental Depression Lowers Treatment Adherence

A recent study published in the journal Pediatrics showed that depression in parents of children with cystic fibrosis (CF) negatively impacts treatment adherence in children taking enzyme supplements. The findings point to the possibility of increasing adherence rates by identifying and treating parental depression.

Studies showed that good nutrition and a healthy weight is important for reducing ill health and increasing lung function in patients with CF. They also leads to better survival.

Children with CF need more energy than healthy children, and the Cystic Fibrosis Foundation (CFF) has provided guidelines that focus on nutrition in childhood, stating that children should eat at least three nutritious meals and three snacks every day. Children who have pancreatic insufficiency also need to take enzyme supplements with each meal and snack. But research found that adherence to these recommendations is low: Just 16 to 28 percent of parents report they stick to the dietary recommendations and 27-46 percent adhere to the enzyme treatment.

There was an ongoing theory that high rates of depression in parents of children with CF would negatively influence treatment adherence, but few studies have investigated the presumed connection.

The new research examined whether parental depressive symptoms could predict adherence to enzyme treatment and whether that impact also affected short-term health outcomes. The study measured adherence during a three-month period in 83 CF children, and the rates of depressive symptoms in parents.

The team observed that 30 percent of the parents had clinical depression, and another 18 percent suffered moderate depressive symptoms. Adherence was found to be higher while children were at school compared to home, and was also higher in toddlers compared to school-age children.

While adherence to enzyme treatment was only 49 percent in the whole group, parental depression was seen to negatively impact adherence. Parents with mild to clinically significant depressive symptoms had children who took enzyme supplements 5.2 fewer times compared to children of non-depressed parents. Moreover, lower adherence was associated with lower weight gain, also affected by depression.

Recently developed international guidelines on mental health in CF recommends annually screening parents of children with cystic fibrosis for symptoms of depression and anxiety. This new study clearly shows that treatment of parental depression may improve treatment adherence and the overall health of children suffering from CF.

The study is titled “Parental Depression and Pancreatic Enzymes Adherence in Children With Cystic Fibrosis,“ and was authored by David H. Barker from the Rhode Island Hospital and Alexandra L. Quittner from the University of Miami.