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Meta-Analysis
. 2023 Feb;58(2):287-298.
doi: 10.1007/s00127-022-02307-w. Epub 2022 Jun 4.

Depression and anxiety prevalence in people with cystic fibrosis and their caregivers: a systematic review and meta-analysis

Louise Lord  1   2 , David McKernon  3 , Luke Grzeskowiak  4   5 , Sue Kirsa  4   6 , Jenni Ilomaki  4   7
Affiliations
Meta-Analysis

Depression and anxiety prevalence in people with cystic fibrosis and their caregivers: a systematic review and meta-analysis

Louise Lord et al. Soc Psychiatry Psychiatr Epidemiol. 2023 Feb.

Abstract

Background: Prevalence of depression and anxiety in people with cystic fibrosis (PwCF) and their caregivers is high, however, results have been inconsistent. This systematic review and meta-analysis aimed to estimate the prevalence of depression and anxiety in PwCF and their caregivers and explore sources of heterogeneity.

Method: MEDLINE, EMBASE, CINAHL plus and PsychINFO databases were searched from inception to January 2021. Studies were included if a specific psychometric tool (PT) to assess depression or anxiety (rather than quality of life) was used and did not involve a transitory patient state. Random-effects models were applied due to high anticipated heterogeneity and I2 estimates were calculated. Sources of heterogeneity were explored through subgroup comparisons. The presence of small-study effects was investigated visually using funnel plots and statistically using the Egger test.

Results: A total of 94 articles (48 full-text publications, 46 abstracts) were included. Depression prevalence in adolescents aged 12-18 years (n = 2386), adults (n = 9206) and caregivers (n = 6617) were 18.7% (95% CI 12.8-25.3%, I2 = 89.2%), 27.2% (95% CI 23.6-31%, I2 = 90.4%), and 32.8% (95% CI 27.9-37.9%, I2 = 90.3%), respectively. Anxiety prevalence in adolescents aged 12-18 years (n = 2142) was 26% (95% CI 19.6-33%, I2 = 86.4%), 28.4% (95% CI 25-31.9%, I2 = 85%) for adults (n = 8175), and 38.4% (95% CI 30.8-46.2%, I2 = 94.6%) for caregivers (n = 5931). Prevalence differed by the PT used and study location.

Discussion: This comprehensive analysis found the prevalence of depression and anxiety in PwCF and their caregivers to be high, supporting recommendations for regular screening. Choice of PT significantly influenced prevalence, indicating a need for future studies to identify the optimal PT for each CF population to identify those most at risk.

Keywords: Anxiety; Cystic fibrosis; Depression; Epidemiology; Prevalence; Psychological tests.

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Conflict of interest statement

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram. CF cystic fibrosis, PT psychometric tool, PwCF people with cystic fibrosis
Fig. 2
Fig. 2
Prevalence of depression in children, adolescents and adults with cystic fibrosis and their caregivers, according to psychometric tool. BDI Beck Depression Inventory, BDIY Beck Depression Inventory for Youth, CESD Center for Epidemiologic Studies Depression Scale, CDI Children’s Depression Inventory, CI Confidence Interval, DASS Depression Anxiety Stress Scale, ES Effect Size, HADS Hospital Anxiety and Depression Scale, K- SADS Kiddie Schedule for Affective Disorders and Schizophrenia, MDI Major Depression Inventory, MFQC Mood and Feelings Questionnaire for Children, PROMIS PROMIS Depression Short Form, PHQ Patient Health Questionnaire, QIDS Quick Inventory of Depressive Symptomatology, RCADS Revised Children's Anxiety and Depression Survey, Zung Zung Self-Rating Depression Scale
Fig. 3
Fig. 3
Prevalence of anxiety in children, adolescents and adults with cystic fibrosis and their caregivers, according to psychometric tool. BAIY Beck Anxiety Inventory for Youth, CI Confidence Interval, DASS Depression Anxiety Stress Scale, ES Effect Size, GAD Generalized Anxiety Disorder 7-item measure, HADS Hospital Anxiety and Depression Scale, PROMIS-SF PROMIS Anxiety Short Form, SCARED Screen for Child Anxiety Related Disorders, SPENCE Spence Children’s Anxiety Scale, STAI State-Trait Anxiety Inventory, STAIC State-Trait Anxiety Inventory for Children
Fig 4.
Fig 4.
Prevalence of depression in children, adolescents and adults with cystic fibrosis and their caregivers, according to World Bank country income categories. CI Confidence Interval, ES Effect Size, HIC High income country, LMIC Low to middle-income country
Fig 5.
Fig 5.
Prevalence of anxiety in children, adolescents and adults with cystic fibrosis and their caregivers, according to World Bank country income categories. CI Confidence Interval, ES Effect Size, HIC High income country, LMIC Low to middle-income country
See this image and copyright information in PMC

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