Children's Hospital of Richmond at Virginia Commonwealth University, 1000East Broad Street, Richmond, VA 23298, USA.
Cystic Fibrosis Foundation, 4550 Montgomery Avenue, Bethesda, MD 20814, USA.
J Cyst Fibros. 2021 Jan;20(1):120-126. doi: 10.1016/j.jcf.2020.07.020. Epub 2020 Aug 13.
The International Depression Epidemiological Study (TIDES) found elevated rates of screen positivity for depression and anxiety among individuals with cystic fibrosis (CF). Depression is associated with worse adherence and health-related quality of life in CF. We investigated the relationship with mortality.
Subjects were untransplanted participants in TIDES 12+ years of age receiving care at one of 45 collaborating US CF care centers who completed the Hospital Anxiety and Depression Scale and/or Center for Epidemiologic Studies Depression Scale during a stable visit between 2006 and 2010. Clinical characteristics and mortality data were obtained from the CF Foundation Patient Registry. The association of a positive screen with 5-year survival was evaluated using Cox Proportional Hazards modeling.
Of 1005 eligible patients, 25% screened positive for depression and 34% screened positive for anxiety. Patients who screened positive for depression were more likely to be older, have a residual function mutation, public insurance, and more pulmonary exacerbations in the screening year. There were 96 deaths. The unadjusted 5-year Hazard Ratio (HR) for death among those with depression was 2.0; 95% CI (1.3, 3.0)]. When adjusted for predetermined potential confounders the HR for the entire population was 1.4; 95% CI (0.9, 2.2). The adjusted HR was higher in adults [1.6; 95% CI (1.0, 2.4)] and those screening in the severe range [2.0; 95% CI (1.2, 3.4)]. Anxiety was not associated with mortality.
A positive depression screen is associated with increased mortality among adults with CF. Research into the etiology of this relationship is needed.
国际抑郁流行病学研究（TIDES）发现，囊性纤维化（CF）患者的抑郁和焦虑症状筛查阳性率较高。抑郁与 CF 患者的治疗依从性和健康相关生活质量下降有关。我们调查了其与死亡率的关系。
TIDES 研究中的未接受移植的参与者，年龄在 12 岁及以上，在 2006 年至 2010 年期间，在稳定期于 45 家美国 CF 护理中心之一就诊时完成了医院焦虑和抑郁量表（HADS）和/或流行病学研究中心抑郁量表（CES-D）。从 CF 基金会患者注册处获取临床特征和死亡率数据。使用 Cox 比例风险模型评估阳性筛查与 5 年生存率的关系。
在 1005 名合格患者中，25%的患者筛查出抑郁，34%的患者筛查出焦虑。筛查出抑郁的患者年龄较大，有残余功能突变，公共保险，以及在筛查年内更频繁的肺部恶化。有 96 人死亡。抑郁患者的未调整 5 年死亡风险比（HR）为 2.0；95%CI（1.3，3.0）。当调整所有潜在混杂因素时，整个人群的 HR 为 1.4；95%CI（0.9，2.2）。在成年人[1.6；95%CI（1.0，2.4）]和筛查处于严重程度的患者[2.0；95%CI（1.2，3.4）]中，调整后的 HR 更高。焦虑与死亡率无关。
CF 成人中阳性抑郁筛查与死亡率增加有关。需要研究这种关系的病因。
