Prevalence of depression and antidepressant therapy use in a pediatric cystic fibrosis population

Abstract

Background: Depression is associated with significant morbidity and mortality. In recent years reports of depression in cystic fibrosis (CF) patients of all ages have increased. As awareness of depression in CF increases, there remains limited data regarding the prevalence and management of depression in the pediatric CF population.

Objectives: To assess the prevalence of depression, describe depression treatment regimens, and identify risk factors for depression in the pediatric CF population at a single care center.

Methods: A retrospective chart review was conducted on 190 patients at 1 accredited CF center. Patient demographics and clinical characteristics were collected and compared between patients with depression and patients without depression. In addition, the treatment strategies of patients with depression were recorded.

Results: The number of patients with a documented diagnosis of depression was found to be 9%, and 50% of these patients were prescribed antidepressant therapy. The most common class of medication prescribed for depression in these patients was the selective serotonin reuptake inhibitors, where fluoxetine was the most common medication. Patients with depression had a lower mean absolute forced expiratory volume in 1 s (1.88 vs 2.48 L; P = .042), more than 5 total hospitalizations per year (4 vs 1; P = .012), and more outpatient CF exacerbations requiring treatment (1.5 vs 0; P = .023) per year than patients without depression.

Conclusion: Identified risk factors may be used to increase depression screening of CF pediatric patients, allowing for early detection and screening in this potentially high-risk patient population. More studies are needed to determine efficacious treatment for depression in pediatric CF patients.

Keywords: antidepressant; cystic fibrosis; depression; pediatrics; pulmonary.