Quon Bradley S, Bentham Wayne D, Unutzer Jurgen, Chan Ya-Fen, Goss Christopher H, Aitken Moira L
Division of Respirology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA.
Psychosomatics. 2015 Jul-Aug;56(4):345-53. doi: 10.1016/j.psym.2014.05.017. Epub 2014 Jun 2.
To examine the prevalence of symptoms of depression and anxiety among patients with cystic fibrosis (CF) who were followed up at the University of Washington Adult CF clinic and to identify sociodemographic and clinical factors associated with symptoms.
A total of 178 adults with CF were asked to complete the Patient Health Questionnaire-9 for depression and General Anxiety Disorder-7 for anxiety when clinically stable. Clinically significant symptoms of depression and anxiety were defined in the following 2 ways: (1) symptom definition-presence of moderate-to-severe symptoms based on the questionnaires and (2) composite definition-symptom definition or the use of psychiatric medications to manage symptoms. Associations between Patient Health Questionnaire-9 and General Anxiety Disorder-7 scores with sociodemographic (gender, age, age of CF diagnosis, vocation, and spousal status) and clinical factors (forced expiratory volume in 1 second, body mass index, and CF-related diabetes on insulin) were examined.
Of 178 patients, 153 (85%) completed the screening questionnaires. Based on the symptom definition, 7% of patients had symptoms of depression and 5% had symptoms of anxiety. Using the composite definition, 22% of patients had symptoms of depression and 10% had symptoms of anxiety. Based on the Patient Health Questionnaire-9, 5% of patients reported suicidal thoughts. In multiple linear regression analysis, only forced expiratory volume in 1 second % predicted was independently associated with Patient Health Questionnaire-9 depression scores, and no sociodemographic or clinical factors were associated with General Anxiety Disorder-7 anxiety scores.
We conclude that all adults with CF should be screened for symptoms of depression and anxiety given the difficulty in identifying strong clinical risk factors and the unexpected high rates of suicidal ideation.
调查在华盛顿大学成人囊性纤维化（CF）诊所接受随访的CF患者中抑郁和焦虑症状的患病率，并确定与这些症状相关的社会人口统计学和临床因素。
共有178名成年CF患者在临床病情稳定时被要求完成用于评估抑郁的患者健康问卷-9（Patient Health Questionnaire-9）和用于评估焦虑的广泛性焦虑障碍量表-7（General Anxiety Disorder-7）。抑郁和焦虑的具有临床意义的症状通过以下两种方式定义：（1）症状定义——基于问卷存在中度至重度症状；（2）综合定义——症状定义或使用精神科药物来控制症状。研究了患者健康问卷-9和广泛性焦虑障碍量表-7得分与社会人口统计学因素（性别、年龄、CF诊断年龄、职业和婚姻状况）以及临床因素（一秒用力呼气量、体重指数和使用胰岛素治疗的CF相关糖尿病）之间的关联。
178名患者中，153名（85%）完成了筛查问卷。根据症状定义，7%的患者有抑郁症状，5%的患者有焦虑症状。使用综合定义时，22%的患者有抑郁症状，10%的患者有焦虑症状。根据患者健康问卷-9，5%的患者报告有自杀念头。在多元线性回归分析中，仅预测的一秒用力呼气量百分比与患者健康问卷-9的抑郁得分独立相关，且没有社会人口统计学或临床因素与广泛性焦虑障碍量表-7的焦虑得分相关。
我们得出结论，鉴于难以识别强有力的临床风险因素以及意外的高自杀意念发生率，所有成年CF患者都应接受抑郁和焦虑症状的筛查。
