(297) Mental Health Symptoms & Physical Health Outcomes in Youth with CF

Background: Youth with Cystic Fibrosis (CF) are faced with frequent pulmonary exacerbations, as well as substantial rates of anxiety and depression.[1, 2] Pulmonary exacerbations and mental health challenges in youth with CF are both associated with negative health outcomes. [3-5] To date, research examining the relationship between mental health symptoms and physical health outcomes has been limited by small variability in symptoms and relatively healthy participants, as well as cross-sectional study design.[6] The primary goal of this presentation is to present results of a longitudinal pilot study which examined the relationships between mental health symptoms and physical health outcomes in youth with CF.

Methods: Medical data, including mental health measures, was extracted from medical records for pediatric CF patients ages 12 – 20 years old from 1/1/2016 to 12/31/2021. As part of standard of care, youth with CF completed mental health screeners, including the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disoder-7 (GAD-7) annually at a clinic visit. Physical health outcomes that were extracted for analyses include BMI trends, FEV₁ trends, hospitalizations, total antibiotic courses, and IV antibiotic courses.

Results: Approximately 70 patients qualified for medical record data abstraction. Data analyses are currently under way. Planned analyses include longitudinal modeling to examine the potential bidirectional relationships between mental health symptoms and selected indicators of physical health. Data analyses will be completed by 6/1/2022 We anticipate associations between mental health symptoms and physical health indicators. We will explore whether mental health symptoms are predictive of physical health outcomes over time.

Conclusions: Results from this study will provide pilot data for future research on the interplay between mental and physical health in youth with CF and has the potential to inform mental health intervention development and clinical care. More specifically, results may identify an at-risk patient population for whom routine care may be insufficient for maintaining health. This would have implications for novel approaches to care, including integrated mental health interventions for those at-risk, as well as increased screening for worsening symptoms to prevent worsening disease course over time.

Acknowledgements:

References: [1] Waters V, Ratjen F. Pulmonary exacerbations in children with cystic fibrosis. Annals of the American Thoracic Society. 2015;12(Supplement 2):S200-S6.

[2] Quittner AL, Goldbeck L, Abbott J, Duff A, Lambrecht P, Sole A, et al. Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries. Thorax. 2014;69(12):1090-7.

[3] Havermans T, Willem L. Prevention of anxiety and depression in cystic fibrosis. Current opinion in pulmonary medicine. 2019;25(6):654-9.

[4] Konstan MW, Morgan WJ, Butler SM, Pasta DJ, Craib ML, Silva SJ, et al. Risk factors for rate of decline in forced expiratory volume in one second in children and adolescents with cystic fibrosis. The Journal of pediatrics. 2007;151(2):134-9. e1.

[5] Britto MT, Kotagal UR, Hornung RW, Atherton HD, Tsevat J, Wilmott RW. Impact of recent pulmonary exacerbations on quality of life in patients with cystic fibrosis. Chest. 2002;121(1):64-72.

[6] Besier T, Goldbeck L. Anxiety and depression in adolescents with CF and their caregivers. Journal of cystic fibrosis. 2011;10(6):435-42.