Department of Neurological Sciences, Unit of Clinical Psychology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Pediatric Pulmonology & Respiratory Intermediate Care Unit, Sleep and Long-Term Ventilation Unit, Academic Department of Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Respir Med. 2023 Feb;207:107095. doi: 10.1016/j.rmed.2022.107095. Epub 2022 Dec 23.
Individuals with chronic respiratory diseases and caregivers are at higher risk for depression and anxiety. Primary ciliary dyskinesia (PCD) and cystic fibrosis (CF) are both rare genetic diseases, characterized by recurrent respiratory infections. This study compared depression and anxiety in people with PCD (pwPCD) and CF (pwCF), and caregivers, using the screening tools recommended in the CF guidelines.
Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) were administered to a PCD and CF sample. Given that PCD is extremely rare, they were matched on age and sex to pwCF at a 1:2 ratio. Similar procedures were performed with parents.
A total of 63 patients and 129 caregivers participated: 21 pwPCD and 42 pwCF (ages 12-34 years) plus 43 caregivers of pwPCD and 86 caregivers of pwCF. A high percentage of patients scored above the cut-off for depression (PCD: 33%; CF: 43%) and anxiety (PCD and CF both: 43%), mostly mild. Similarly, a high percentage of caregivers scored above the cut-off for depression (PCD: 42-54%; CF: 45-46%) and anxiety (PCD: 47-54%; CF: 39-56%). Suicidal ideation was endorsed by 9.5% of pwPCD, 20% of mothers and 10% of fathers and 5% of pwCF, 3% of mothers, but no fathers.
A large percentage of patients and caregivers reported elevated psychological distress and suicidal ideation. Addressing psychological symptoms is critical given they are associated with poor adherence, missed clinic visits, increased inflammation and worse quality of life. Mental health screening and treatment should be integrated into PCD care.
患有慢性呼吸系统疾病的患者及其护理人员患抑郁症和焦虑症的风险较高。原发性纤毛运动障碍(PCD)和囊性纤维化(CF)均为罕见的遗传性疾病,其特征为反复发生呼吸道感染。本研究使用 CF 指南中推荐的筛选工具,比较了 PCD(pwPCD)和 CF(pwCF)患者及其护理人员的抑郁和焦虑情况。
对 PCD 和 CF 样本进行患者健康问卷(PHQ-9)和广泛性焦虑症(GAD-7)测试。由于 PCD 极其罕见,因此将其与 pwCF 按年龄和性别 1:2 进行匹配。对父母进行了类似的操作。
共有 63 名患者和 129 名护理人员参与:21 名 pwPCD 和 42 名 pwCF(年龄 12-34 岁),加上 43 名 pwPCD 的护理人员和 86 名 pwCF 的护理人员。许多患者的抑郁评分(PCD:33%;CF:43%)和焦虑评分(PCD 和 CF 均为:43%)都高于临界值,且多为轻度。同样,许多护理人员的抑郁评分(PCD:42%-54%;CF:45%-46%)和焦虑评分(PCD:47%-54%;CF:39%-56%)均高于临界值。9.5%的 pwPCD、20%的母亲和 10%的父亲以及 5%的 pwCF、3%的母亲有自杀意念,但没有父亲。
很大比例的患者和护理人员报告存在心理健康困扰和自杀意念。鉴于这些心理症状与较差的依从性、错过就诊、炎症增加和生活质量下降有关,因此解决这些问题至关重要。应将心理健康筛查和治疗纳入 PCD 护理中。