Quittner Alexandra L, Abbott Janice, Georgiopoulos Anna M, Goldbeck Lutz, Smith Beth, Hempstead Sarah E, Marshall Bruce, Sabadosa Kathryn A, Elborn Stuart
University of Miami, Coral Gables, Florida, USA.
School of Psychology, University of Central Lancashire, Preston, UK.
Thorax. 2016 Jan;71(1):26-34. doi: 10.1136/thoraxjnl-2015-207488. Epub 2015 Oct 9.
Studies measuring psychological distress in individuals with cystic fibrosis (CF) have found high rates of both depression and anxiety. Psychological symptoms in both individuals with CF and parent caregivers have been associated with decreased lung function, lower body mass index, worse adherence, worse health-related quality of life, more frequent hospitalisations and increased healthcare costs. To identify and treat depression and anxiety in CF, the CF Foundation and the European CF Society invited a panel of experts, including physicians, psychologists, psychiatrists, nurses, social workers, a pharmacist, parents and an individual with CF, to develop consensus recommendations for clinical care. Over 18 months, this 22-member committee was divided into four workgroups: Screening; Psychological Interventions; Pharmacological Treatments and Implementation and Future Research, and used the Population, Intervention, Comparison, Outcome methodology to develop questions for literature search and review. Searches were conducted in PubMed, PsychINFO, ScienceDirect, Google Scholar, Psychiatry online and ABDATA by a methodologist at Dartmouth. The committee reviewed 344 articles, drafted statements and set an 80% acceptance for each recommendation statement as a consensus threshold prior to an anonymous voting process. Fifteen guideline recommendation statements for screening and treatment of depression and anxiety in individuals with CF and parent caregivers were finalised by vote. As these recommendations are implemented in CF centres internationally, the process of dissemination, implementation and resource provision should be closely monitored to assess barriers and concerns, validity and use.
对囊性纤维化(CF)患者心理困扰的研究发现,抑郁症和焦虑症的发病率都很高。CF患者及其家长照顾者的心理症状都与肺功能下降、较低的体重指数、较差的依从性、较差的健康相关生活质量、更频繁的住院治疗以及更高的医疗成本有关。为了识别和治疗CF患者的抑郁症和焦虑症,CF基金会和欧洲CF协会邀请了一个专家小组,包括医生、心理学家、精神科医生、护士、社会工作者、药剂师、家长以及一名CF患者,共同制定临床护理的共识性建议。在18个多月的时间里,这个由22名成员组成的委员会被分成了四个工作组:筛查;心理干预;药物治疗以及实施与未来研究,并采用人群、干预措施、对照、结果的方法来提出文献检索和综述的问题。由达特茅斯学院的一名方法学家在PubMed、PsychINFO、ScienceDirect、谷歌学术、精神病学在线和ABDATA中进行检索。委员会审查了344篇文章,起草了声明,并在匿名投票过程之前将每条建议声明80%的接受率设定为共识阈值。通过投票最终确定了15条关于CF患者及其家长照顾者抑郁症和焦虑症筛查与治疗的指南建议声明。随着这些建议在国际CF中心的实施,应密切监测传播、实施和资源提供的过程,以评估障碍和问题、有效性及实用性。