Rozov Tatiana, Silva Marcos Tadeu Nolasco da, Ribeiro Maria Ângela Gonçalves Oliveira, Damaceno Neiva, Santana Maria Angelica Pinheiro Santos, Marostica Paulo Jose Cauduro, Melotti Roberta de Cássia Nunes Cruz, Martins Valeria de Carvalho, Riedi Carlos Antônio, Souza Edna Lucia Santos de, Ludwig Neto Norberto, Athanazio Rodrigo Abensur, Yamamoto Francyelly Wisnievski, Costa Lusmaia Damaceno Camargo, Chiba Sonia Mayumi, Sad Izabela, Ribeiro José Dirceu, Quittner Alexandra L
. Universidade de São Paulo, São Paulo (SP) Brasil.
. Universidade Estadual de Campinas, Campinas (SP) Brasil.
J Bras Pneumol. 2025 Jun 13;51(2):e20240416. doi: 10.36416/1806-3756/e20240416. eCollection 2025.
Depression and anxiety have been documented in people with cystic fibrosis (CF), jeopardizing treatment adherence. To date, no studies have assessed the prevalence of psychosocial issues in adolescents with CF in Brazil. We sought to assess the prevalence of depression and anxiety in adolescents with CF in Brazil, as well as the impact of depression and anxiety on treatment adherence.
This was a multicenter, prospective, observational, longitudinal study conducted between 2017 and 2019 at 14 CF referral centers in Brazil. We used standardized tools such as the nine-item Patient Health Questionnaire (for depression), the seven-item Generalized Anxiety Disorder scale (for anxiety), and the eight-item Morisky Medication Adherence Scale (for treatment adherence) in order to collect data on 218 CF patients at two different time points.
The prevalence of depression was 19.1% at time point 1 and 15.4% at time point 2. The prevalence of anxiety was 19.1% at time point 1 and 18.0% at time point 2. Depression and anxiety were significantly higher in female patients and lower in those who underwent home physiotherapy or had psychological support. Significant correlations were found between depression and anxiety at both time points, the associations being strongest at time point 1 (r = 0.68; p < 0.001). Most (66.7%) of the study participants reported low adherence to treatment, and the remainder reported either average adherence (in 28%) or high adherence (in 5.3%). Depression and anxiety showed inverse correlations with treatment adherence.
The prevalence of depression and anxiety in adolescents with CF in Brazil appears to be similar to that reported in other countries, being higher in females and lower in those undergoing home physiotherapy or receiving psychological care. Depression and anxiety appear to correlate with lower treatment adherence. Treating psychosocial issues may effectively improve rates of treatment adherence in adolescents with CF.
囊性纤维化（CF）患者中存在抑郁和焦虑现象，这会影响治疗依从性。迄今为止，尚无研究评估巴西CF青少年患者心理社会问题的患病率。我们旨在评估巴西CF青少年患者中抑郁和焦虑的患病率，以及抑郁和焦虑对治疗依从性的影响。
这是一项多中心、前瞻性、观察性纵向研究，于2017年至2019年在巴西的14个CF转诊中心进行。我们使用标准化工具，如九项患者健康问卷（用于评估抑郁）、七项广泛性焦虑障碍量表（用于评估焦虑）和八项Morisky药物依从性量表（用于评估治疗依从性），以便在两个不同时间点收集218名CF患者的数据。
在时间点1，抑郁患病率为19.1%，在时间点2为15.4%。在时间点1，焦虑患病率为19.1%，在时间点2为18.0%。女性患者的抑郁和焦虑患病率显著更高，而接受家庭物理治疗或获得心理支持的患者患病率较低。在两个时间点，抑郁和焦虑之间均存在显著相关性，在时间点1相关性最强（r = 0.68；p < 0.001）。大多数（66.7%）研究参与者报告治疗依从性低，其余参与者报告依从性一般（28%）或依从性高（5.3%）。抑郁和焦虑与治疗依从性呈负相关。
巴西CF青少年患者中抑郁和焦虑的患病率似乎与其他国家报告的相似，女性患病率更高，接受家庭物理治疗或接受心理护理的患者患病率较低。抑郁和焦虑似乎与较低的治疗依从性相关。治疗心理社会问题可能有效提高CF青少年患者的治疗依从率。
